Psoriasis

Clinical Presentation and Symptoms

The clinical manifestations of psoriasis are diverse, but most patients experience:

• Erythematous plaques with overlying silvery-white scale
• Pruritus, burning, or discomfort in affected areas
• Fissuring or bleeding of the skin
• Nail dystrophy (pitting, onycholysis, or subungual hyperkeratosis)
• Joint symptoms in psoriatic arthritis, which may coexist

Commonly affected sites include the scalp, elbows, knees, trunk, and lower back, though lesions may appear anywhere on the body.

Types of Psoriasis

There are several distinct clinical subtypes of psoriasis, each with unique characteristics.  performs a thorough dermatologic evaluation to determine the type and severity of your condition, which guides the selection of targeted interventions.

1. Plaque Psoriasis (Psoriasis Vulgaris)

The most prevalent form, presenting as well-demarcated plaques covered by white or silver scale. Commonly affects the scalp, extensor surfaces, and sacral region.

2. Guttate Psoriasis

Typically arises in children and young adults, often following a streptococcal infection. Lesions appear as small, drop-like papules across the trunk and proximal extremities.

3. Pustular Psoriasis

Characterized by sterile pustules on an erythematous base, this variant may be localized (e.g., palms and soles) or generalized, which can be severe and systemic in nature.

4. Inverse Psoriasis

Manifests as smooth, shiny erythematous plaques in intertriginous areas, such as the axillae, inframammary folds, and groin. It is often exacerbated by friction and perspiration.

5. Erythrodermic Psoriasis

A rare, potentially life-threatening form involving widespread erythema, exfoliation, and systemic symptoms such as fever, chills, and dehydration. This condition requires immediate medical intervention.

Therapeutic Approaches

While psoriasis is incurable, a variety of therapies are available to attenuate symptoms, control inflammation, and restore skin homeostasis. Dr. Patel develops individualized treatment plans based on disease subtype, severity, patient comorbidities, and treatment preferences.

Topical Therapies

• Corticosteroids: Reduce inflammation and immune activity
• Vitamin D analogs (e.g., calcipotriene): Normalize keratinocyte proliferation
• Salicylic acid: Promotes desquamation of scale
• Emollients and moisturizers: Support skin barrier function and relieve dryness

Systemic and Biologic Therapies

• Biologic agents (e.g., TNF-alpha inhibitors, IL-17 or IL-23 inhibitors): Target specific immune pathways
• Immunosuppressants (e.g., methotrexate, cyclosporine): Reduce immune system overactivity
• Oral retinoids: Modulate epidermal differentiation

Phototherapy

• Narrowband UVB therapy: Effective in reducing plaque thickness and inflammation with minimal systemic effects

Lifestyle and Supportive Measures

• Stress reduction techniques, as psychological stress is a known exacerbating factor
• Nutritional counseling to reduce systemic inflammation
• Avoidance of triggers such as smoking, alcohol, and skin trauma (Koebner phenomenon)

Consultation and Ongoing Management

With the right therapeutic strategy and consistent follow-up, most individuals with psoriasis can achieve substantial symptomatic improvement and lead a high-quality life. At CoCo Dermatology and Cosmetics are committed to providing comprehensive, compassionate, and cutting-edge care to patients managing psoriasis and its complexities.

To initiate your personalized care plan, please contact our office by phone or schedule a consultation online today.