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Medical & Surgical Dermatology

Psoriasis

Psoriasis (sore-EYE-ah-sis) is a medical condition that occurs when skin cells grow too quickly. Faulty signals in the immune system cause new skin cells to form in days rather than weeks. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and lesions form. The lesions vary in appearance with the type of psoriasis. There are five types of psoriasis:

  • plaque
  • guttae
  • pustular
  • inverse
  • erythrodermic

About 80% of people living with psoriasis have plaque psoriasis also called "psoriasis vulgaris.” Plaque psoriasis causes patches of thick, scaly skin that may be white, silvery, or red. Called plaques, these patches can develop anywhere on the skin. The most common areas to find plaques are the elbows, knees, lower back, and scalp. Psoriasis also can affect the nails. About 50% of people who develop psoriasis see changes in their fingernails and/or toenails. If the nails begin to pull away from the nail bed or develop pitting, ridges, or a yellowish-orange color, this could be a sign of psoriatic (sore-EE-at-ic) arthritis. Without treatment, psoriatic arthritis can progress and become debilitating. 

For some people, psoriasis is a nuisance. Others find that psoriasis affects every aspect of their daily life. The unpredictable nature of psoriasis may be the reason. Psoriasis is a chronic (lifelong) medical condition. Some people have frequent flare-ups that occur weekly or monthly. Others have occasional flare-ups.

When psoriasis flares, it can cause severe itching and pain. Sometimes the skin cracks and bleeds. When trying to sleep, cracking and bleeding skin can wake a person frequently and cause sleep deprivation. A lack of sleep can make it difficult to focus at school or work. Sometimes a flare-up requires a visit to a dermatologist for additional treatment. Time must be taken from school or work to visit the doctor and get treatment.

These cycles of flare-ups and remissions often lead to feelings of sadness, despair, guilt and anger as well as low self-esteem. Depression is higher in people who have psoriasis than in the general population. Feelings of embarrassment also are common.

Psoriasis Treatment

Psoriasis treatments fall into 3 categories:

  • Topical (applied to the skin) – Mild to moderate psoriasis

  • Phototherapy (light, usually ultraviolet, applied to the skin) – Moderate to severe psoriasis

  • Systemic (taken orally or by injection or infusion) – Moderate, severe or disabling psoriasis

Currently, there is no cure for psoriasis. However, there are many treatment options that can clear psoriasis for a period of time. Each treatment has advantages and disadvantages, and what works for one patient may not be effective for another.  Dr Misssy Clifton, a board-certified dermatologist has the medical training and experience needed to determine the most appropriate treatments for each patient.