Psoriasis and Phototherapy Center

Psoriasis and Phototherapy Center

Psoriasis is a common, chronic, non-contagious recurring skin condition consisting of red, scaly, well-defined, thickened areas of varying sizes. Any part of your skin on the body and on your nails can be affected. The scalp, elbows, knees and lower back are commonly affected, but the face is usually not. Arthritis may be associated with your psoriasis. We encourage all patients with psoriasis to join the National Psoriasis Foundation.

Key Points

Who can get psoriasis?

Psoriasis affects approximately 2% of the population (4.5-7 million Americans); men and women in any age group can be affected. The moste common type of psoriasis usually begins between the ages of 20 and 30 and runs in families, but the inheritance is variable. A number of genetic associations (for example, a gene called HLA-Cw6) have been linked. Approximately 30% of people with this condition also have a first degree relative (that is parents, brothers, sisters and children) with psoriasis.

If you have an identical twin with psoriasis, the chance that you also have the condition is about 70%, while the risk for a twin who is not identical, is about 25%. The severity of psoriasis may vary between family members. For example, one member might be covered with psoriasis and another family member may have minimal psoriasis or possibly psoriatic arthritis only.

What causes Psoriasis?

The exact cause of psoriasis is unknown, but it is known that psoriasis is an autoimmune condition involving the T-lymphocyte, a type of white blood cell. In psoriasis patients, some parts of the immune system are “turned on” which causes inflammation in the skin and sometimes arthritis. This inflammation causes skin cells to be manufactured and shed much faster than in normal skin. The current theory on treating psoriasis is to reduce the immune reaction that causes psoriasis. In one type of psoriasis (guttate psoriasis) patients will develop their first episode of psoriasis after a bad strep infection.

Are there any other associated medical problems associated with psoriasis?

Arthritis is found in 15-25% of psoriasis patients but in most patients psoriasis occurs about 10 years prior to the development of psoriatic arthritis. This type of arthritis commonly presents as stiffness in the morning or after long periods in one position (sitting in a car for long periods). It can also affect the small joints in the fingers, wrists, ankles, or back. In many situations, our psoriasis patients are managed in conjunction with a rheumatologist.

There is new information that suggests psoriasis may be associated with other medical problems including heart disease, obesity, diabetes, and lymphoma. For this reason, we suggest all psoriasis patients keep close follow up with their primary care physicians and live a healthy life style.

How is psoriasis treated?

Systemic and Topical Therapy

We use all systemic and topical therapy for psoriasis including the following internal therapies: Biologic Therapy, Methotrexate, Cyclosporine, Soriatane, and Isotretinoin (formerly known as Accutane.) We take special care to monitor all appropriate blood work in any patient on these medications. Topical medications we use include topical steroids, Taclonex, Vectical, Dovonex, Protopic, Elidel, over the counter tar preparations and other compounded and non-compounded therapies.

Biologic Therapy

This is the newest systemic therapy for psoriasis. We have been using biologic medications since they were first approved by the FDA for psoriasis in 2003 and have done some of the key pivotal clinical trials for new biologic medications. Our practice has the largest group of patients in Alabama on biologic medications including: Amevive, Enbrel, Humira, Remicade, and Stelara.

Phototherapy

Phototherapy has been used for psoriasis for more almost 100 years and is extremely safe. We have a large up-to-date phototherapy center with two total body phototherapy units equipped with Narrow Band UVB and UVA lights. We also have a hand/foot unit equipped with narrow Band UVB that is used for patients with difficult hand/foot psoriasis and eczema. We have a full time nurse dedicated to phototherapy and other special psoriasis needs.

Laser Therapy

The PHAROS excimer laser is different from cosmetic lasers that are usually associated with pain during treatment and post-treatment downtime for the patient. Instead, the PHAROS delivers a highly energetic but painless beam of UVB light directly to the psoriasis, vitiligo, and atopic dermatitis patches through a handpiece that rests directly on the patient’s skin. It features the most advanced optical technology on the market, including an adjustable spot size and guiding aiming beam, to target precisely only the affected skin and spare the surrounding healthy tissue from exposure. There is no downtime for the patients.
Patients come in twice each week for an average of 6 weeks, and each quick treatment session that usually takes only 5-10 minutes. Patients usually enjoy several months of treatment-free remission.
Equally exciting for psoriasis patients, the targeted high-dose laser therapy can effectively treat stubborn plaques including knees, elbows, palms, soles, and scalp, even those that have not responded to other treatments.

There are many treatment options for psoriasis that are all available at Total Skin and Beauty Dermatology Center. Patients with localized disease are treated with topical steroid preparations (creams, ointments, foams, solutions, gels), tar preparations, Vitamin D creams or ointments, or with XTRAC laser therapy. More extensive psoriasis is treated with ultraviolet light therapy in our state of the art phototherapy center. Many psoriasis patients are treated with systemic therapy such as Methotrexate, Soriatane, or Cylosporine.

The newest drugs for psoriasis are called biologic medications. These drugs work by suppressing a particular part of the immune system that is most critical for the development of psoriasis. They are all given by injection, either in the office or at home. The current approved biologic medications for psoriasis include Amevive, Enbrel, Humira, Remicade, and Stelara. We will work with you to find the most appropriate and safest medication to treat your psoriasis. Total Skin and Beauty Dermatology Center is a regional referral center for psoriasis patients in Alabama and in surrounding states. We encourage our psoriasis patients to join the National Psoriasis Foundation to read more about psoriasis. Also watch an interactive educational video from the National Psoriasis Foundation on causes, types, and treatments of Psoriasis.

Psoriasis Clinical Research Trials

We are frequently involved in clinical research trials for new psoriasis medications. We typically have Phase II, Phase III and Phase IV psoriasis research trials underway. Our psoriasis clinical research unit has been active in trials with Amevive, Enbrel, Humira and other investigational drugs. Call our psoriasis clinical research coordinator to see if any trials might be appropriate for you.

Psoriasis is an autoimmune condition involving the T-lymphocyte, a type of white blood cell.