Bahr Dermatology


Whether your skin needs medical, surgical or cosmetic treatment, trust the expert care of a board-certified dermatologist.

If you have Psoriasis, you are not alone. Millions of people live with this chronic (long-lasting) condition. Some people who have psoriasis develop a type of arthritis known as psoriatic arthritis. Learning about both these conditions can help you manage this disease and improve your quality of life.

How did I get it?

Researchers have learned that a person’s immune system and genes play important roles in developing psoriasis. It seems that many genes must interact to cause this condition.

While you may have a blood relative who has psoriasis, scientists have learned that not everyone who inherits genes for psoriasis gets it. For it to appear, it seems that you must inherit the right mix of genes and be exposed to a trigger. Further research is needed to identify which specific genes cause this skin disorder.

Most people typically develop psoriasis between the ages of 15-25, although it can begin at any age. This condition affects men and women equally, and it occurs in all races.

What triggers Psoriasis?

Different people have different triggers. Common triggers include stress, strep throat, a bad sunburn, or a trauma to the skin. For some people, the disease flares about 10 to 14 days after they injure their skin. Smoking and obesity can be triggers. Some medications can be triggers, including lithium, interferon, drugs taken to lower blood pressure and some medications taken to prevent malaria.

What Is Psoriasis?

Typically, new skin cells form over several weeks. With psoriasis, new cells are made too quickly and build up into raised pink plaques with silver-white scales

It is not contagious and cannot be spread from person to person. You cannot catch it from someone else, or from touching a psoriasis patch.

What does it look like?

There are different types of psoriasis. Each type appears differently on the skin.

  • Most common form, appearing in 80-90% of patients.
  • Looks like patches raised, round to oval, red skin, which can be covered by silvery-white scale.
  • Plaques can be few or covering almost the entire body.
  • Patches can occur anywhere on the skin but typically form on the scalp, trunk, buttocks, and elbows and knees.
  • Occurs in about 2% of psoriasis patients.
  • If you have plaque and it develops to guttate, it may mean your condition is worsening.
  • Most common in individuals under 30.
  • Appears as small pink bumps with a fine scale on the skin.
  • Occurs primarily on the trunk and portions of limbs close to the trunk.
  • Often appears 2-3 weeks after you had a cold, especially sore throat.
  • Appears all over the body or can just be on the palms of the hands and soles of the feet.
  • Looks like white pus-filled bumps surrounded by red skin.
  • Fever and flu-like symptoms can occur if it appears all over the body.
  • Develops only in the folds of the skin, such as the armpits, groin, under the breasts, and in the crease of the buttocks.
  • Skin looks raw with red, smooth patches.
  • There is typically minimal scale with this type.
  • Least common form.
  • Causes severe redness and shedding of the skin over much of the body.
  • Varying degrees of scale can be present.
  • Fever and flu-like symptoms are common.
  • Affects the fingernails and toenails.
  • Causes tiny holes in the nails, which may cause them to loosen, thicken, and eventually crumble.
  • Can occur in all types.
  • Often misdiagnosed as a fungal nail infection.
  • May be a sign of psoriasis arthritis, especially if you have psoriasis on your scalp or the inverse type.

What is Psoriatic Arthritis?

This is a type of arthritis that can occur if you have psoriasis. The first sign of arthritis is frequently swollen, stiff, and sometimes painful joints when waking up. If these signs of arthritis start to happen, contact your dermatologist right away.

Like psoriasis, this arthritis is a lifelong condition. If the arthritis worsens, the affected joins can weaken. This is why it is so important to tell a dermatologist about joint problems. Treatment for this arthritis may include physical therapy, arthritis-friendly exercise and medicine. There are medicines that can prevent psoriatic arthritis from worsening.

How are psoriasis and associated arthritis diagnosed?

Dermatologists make diagnoses by examining your skin, nails, and scalp. Sometimes a dermatologist may need to perform a biopsy to make the diagnosis, which involves removing a small piece of skin or nail. The removed skin will be sent to a lab where it will be examined under a microscope.

A single medical test is not available to diagnose this type of arthritis. To find out if you have arthritis, your dermatologist will ask you questions about your psoriasis, such as whether any of your blood relatives have these conditions. They will ask you questions about fatigue, pain, stiffness and tenderness in your joints and tendons, and swelling of your fingers. They will also examine your joints and may send you for medical tests such as x-rays and blood tests to determine if you have arthritis.

No one blood test can tell whether you have arthritis. Lab testing can confirm if you have inflammation throughout your body as is seen in many people who have both psoriasis and related arthritis. Other blood tests can tell your dermatologist if you have other forms of arthritis that may look like psoriatic arthritis.

Does it just affect my skin?

Having psoriasis increases your risk for certain other health conditions such as arthritis, diabetes, high blood pressure, obesity, high cholesterol, and heart disease. As a result, it is important for you to monitor your health very closely for signs of these diseases, especially if you have a severe condition of this skin disorder. Talking with both your dermatologist and your primary care doctor can ensure that signs of these other conditions can be caught early and treated properly.

How is it treated?

Once psoriasis appears, it does not go away on its own. Treatment can clear plaques and reduce symptoms in many people but it does not cure the disease.

Because the disease can be stubborn, finding the right treatment can take time. Your dermatologist may recommend more than one type of treatment or use a combination of treatments to see the best results. Also, treatments may stop working, so other treatments are needed.

It is important to remember that no matter what treatment you and your dermatologist choose, you should use it exactly as prescribed. Many treatments can produce unwanted side effects. You and your dermatologist will discuss the benefits and risks of a possible treatment to determine what is best for you.

There are different kinds of treatment:

  • Topical Medicine: Topical medicine is applied to the skin. There are many different types of topical medications that can help control mild to moderate conditions. They decrease the rate at which skin cells grow and reduce inflammation

  • Laser/Light Therapy: Under a dermatologist’s care, light therapy can provide safe and effective treatment. Because too much ultraviolet (UV) light can make psoriasis worse and certain types of UV light can increase your risk for skin cancer, it is important to see a dermatologist for treatment. Never try to self-treat your condition by using an indoor tanning bed or by seeking the sun outdoors. Overexposure to UV light can increase your risk for skin cancer.

    Talk with your dermatologist about this treatment option, since light therapy is not appropriate for people with sensitive skin or those who easily sunburn. In addition, many treatments are required, which can make this a challenging treatment.

  • Systemic Medicine: Systemic medicine works throughout the body. These medications are used to treat moderate to severe circumstances. Systemic medication is most commonly swallowed, but can be injected, or infused (through an IV). While effective, some of these medications can only be used for a limited time and may be combined and rotated to minimize side effects.

  • Biologics: If you have moderate to severe psoriasis or arthritis, and other treatments have not been successful, a biologic may be an effective treatment option. Some of the biologics may even slow or stop the joint damage of arthritis. Biologics are given by injection or through an IV. Some shots can be injected at home. To receive an IV, you must go to the dermatologist’s office, treatment center, or hospital for treatment.

How do I manage it daily?

Psoriasis is a long-lasting disease. Here are some things you can do that will help you take control:

  • Learn as much as you can about this skin disease
    Learning about psoriasis, related arthritis, and available treatment options will help you make informed decisions.

  • Take good care of yourself
    Eat a healthy diet, exercise, do not smoke and drink very little alcohol. Smoking, drinking, and being overweight make it worse. These can also make treatment less effective. People who have psoriasis also have an increased risk for developing heart disease, diabetes, arthritis, and other diseases.

  • Be careful about the sun
    Overexposure to the sun or UV light from indoor tanning can cause sunburn, which can worsen your skin and increase the number of plaques being formed on your skin. Every day, wear a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or higher. Talk with your dermatologist about a sunscreen that is right for your skin.

  • Be aware of your joints
    If your joints feel stiff and sore, especially when you wake up, talk with your dermatologist, as this could be a sign of arthritis.

  • Pay attention to your mood
    If you feel depressed, you may want to join a support group or see a mental health professional. Talking with other patients can help you learn to live with psoriasis.

  • Talk with your dermatologist before you stop taking medicine
    Stopping a medicine can have serious consequences.

Taking an active role in managing your psoriasis or arthritis can make a big difference in improving your health, reducing the appearance of plaques and the pain of arthritis, and improving your overall quality of life. Your dermatologist can be a partner in helping you find the treatments that work best for you.


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