PSORIASIS

---

What is Psoriasis?

Psoriasis  is an immune-mediated inflammatory disease that causes itchy, raised, scaly patches on the elbows, knees, scalp, lower back, face, palms and soles, but can also affect other places (fingernails, toenails, and mouth). The most common type of psoriasis is called plaque psoriasis.  The inflammation is systemic, associated with metabolic and other internal conditions, and many people also have arthritis due to psoriasis.  As with other skin conditions, there is a genetic propensity, but diet, lifestyle, and environmental factors play an important role.  

Treatment

There are excellent treatments for psoriasis, with many new options recently approved.  Treatments include topicals, orals, and injections.  We also provide our updated Diet and Lifestyle Guidelines pdf with useful recommendations for all initial psoriasis consultations.  

Topical Treatments

Several topical options are available to safely and effectively control localized psoriasis plaques, including:

• cortisone-based creams, sprays and foams;
• Vitamin-D (calcipotriene);
• non-steroidal anti-inflammatory topicals, including the recently-approved:
• Vtama  (tapinarof), and
• Zoryve  (roflumilast).

Oral Treatments

Oral treatments are more effective and can treat more wide-spread disease than topicals, but have a higher chance for side-effects and may require blood test monitoring. The currently  preferred oral treatments for psoriasis are:

• Otezla (apremilast), which requires no blood test monitoring, but may may cause stomach upsets, weight loss, and exacerbate depression;
•  Sotyktu (deucravacitinib), a recently approved oral medication that appears to be more effective than Otezla, and as effective as the Biological Injections, but does require monitoring and may increase the chance of infections, muscle problems, and possibly certain tumors.