Psoriasis is a common chronic inflammatory skin condition characterised by scaly plaques typically over the scalp, elbows and knees. It affects around one in twenty people.
Generally it begins in late adolescents and early adults and typically lasts for life. There is no cure and in some cases treatment is lifelong. Genetics play an important role in the condition. The condition is mediated by the persons immune system but some environmental ‘triggers’ also exist. It does not just affect the skin.
Triggers include mediations, infections, sore throats, smoking, obesity, alcohol, stress and injury to the skin.
We are learning more and more about its associations with other conditions such as arthritis, bowel disease, eye disease, obesity, high blood pressure, high cholesterol, heart disease and diabetes.
There are many treatment options including topical agents such as moisturisers, topical corticosteroids, topical vit D simulates, topical calcinuirin inhiboitors, tar preparations and topical dithranol.
Phototherapy is another useful treatment. Some patients with severe disease need to take oral tablets and these include acitretin, methotrexate and cyclosporine. There are new ‘biologic agents’ now available but they are expensive and in order to qualify for the PBS to subsidise them, patients need to have exhausted the majority of the other options available.