1. Health

Questions to Ask the Dermatologist About Psoriasis

From Maureen Salamon

Updated May 28, 2008

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

(LifeWire) - Those red spots on your skin that cropped up days or weeks ago have not gone away, and the dermatologist just handed you an unexpected, baffling diagnosis -- psoriasis. What questions should you ask the doctor? Where can you find more information about psoriasis?

"Internet research is fine, but you should ask questions in the dermatologist's office because it builds a relationship with the physician and helps you feel comfortable with the answers," says Doris J. Day, MD, clinical assistant professor of dermatology at New York University Medical Center. "You can have a dialogue, and it gives the physician an idea of how concerned the patient is."

Here is a list of suggested psoriasis questions from Dr. Day, along with some potential answers you may hear from your own doctor:

What is Psoriasis?

Psoriasis is a chronic, lifelong skin disease affecting approximately 2% of the population -- 6 million Americans of all ages. The disease arises from an immune system disorder that causes skin cells to reproduce and turn over much faster than normal, resulting in thick patches of red, inflamed skin (plaques), which are often topped with silvery scales.

How Did I Get It?

Approximately one third of all individuals with psoriasis (called "psoriatics") also have one or more relatives with the disorder, so you could be genetically predisposed toward developing it. Triggers of this condition include stress, smoking, heavy alcohol consumption, sunburn or other injury to the skin, certain medications, and some types of infection, such as strep throat.

Is It Contagious?

No. No one can develop psoriasis from touching you or being around you, nor can you "catch it" from someone who has it.

What Kind Of Psoriasis Do I Have?

There are several variations of psoriasis, which are defined by the size, shape and site of lesions. These include:

  • Plaque Psoriasis: The most common type of psoriasis, which causes scaly red circles on the skin
  • Guttate Psoriasis: Appears as smaller lesions shaped like drops; most often occurs on the scalp, trunk, arms and legs after an infection
  • Pustular Psoriasis: Produces blisters of non-infectious pus
  • Inverse Psoriasis: Appears as smooth red lesions in the folds of skin near the genitals, or under breasts or the armpits
  • Erythrodermic PsoriasisThe least common type of psoriasis, which can cover the entire body in a burning, itchy rash that peels

Other variants of this disease include nail psoriasis, which can pit and discolor the nails on fingers or toes, and scalp psoriasis, which involves flaking of skin on the scalp that can range in severity from dandruff-like flakes to thick scales (it often extends beyond the hairline, as well). Psoriatic arthritis, another type, affects approximately 10 of individuals with psoriasis and causes joint pain and stiffness common to other forms of arthritis.

How Is Psoriasis Treated?

Treatment of psoriasis depends on the severity and location of lesions, as well as other symptoms. Many individuals with mild forms of psoriasis use topical creams and ointments to calm the outbreaks. Individuals whose plaques are more widespread may opt for phototherapy, which uses ultraviolet light to reduce and calm lesions. People with psoriasis who experience lesions over 30% of their body or more - only about one-third of all diagnosed - may opt for systemic treatments, which include pills or injectable medications called biologics. A doctor should monitor the effects of any of these treatments.

What Should I Do If Treatment Does Not Work?

You will know if your treatment is working because plaques will start losing their scales and then slowly fade to a pink color, until they gradually assume your natural skin color again (if remission is maintained). If treatment does not work, your doctor will likely try one of the many other options available until you achieve some relief. This may be a lengthy process: Sometimes psoriasis responds to a certain treatment for a while, only to become resistant and require a different approach later on.

What Effect Will Psoriasis Have On My Life?

The answer to this question largely hinges on the type and severity of your psoriasis, as well as your own emotions. The burden of treating the condition can be taxing for many, as can emotionally dealing with concerns about appearance.  "For some, it can be debilitating if they are half-covered with plaques," Day says, "and for others, with the same amount, it can be no big deal." Seeking out information on managing your condition and finding support can help make living with psoriasis a bit easier on you.

Sources: Doris J. Day, clinical assistant professor of dermatology, NYU Medical Center. Telephone interview, 21 April 2008.

"Psoriasis." National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse. May 2003. National Institutes of Health. 11 Apr. 2008. <http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp>.

 "Psoriasis." Mayo Clinic. 20 Mar. 2007. Mayo Foundation for Medical Education and Research. 15 Apr. 2008. <http://www.mayoclinic.com/print/psoriasis/DS00193/METHOD=pr>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Maureen Salamon is a freelance writer in New Jersey who has written for newspapers, websites and hospitals. She has suffered from psoriasis for nearly three decades.

©2013 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.