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Alternative names: [Chronic plaque, guttate, nummular/discoid, palmoplantar pustular, pustular, annular pustular, generalized pustular] - psoriasis, seborrhoeic dermatitis, sebopsoriasis
If Psoriasis is affecting your life, then the Harley Street Dermatology Clinic is here to help. Our consultant dermatologists can offer you expert treatment with a very good chance of dramatically improving your psoriasis. Please look below at the images of psoriasis before and after treatment. We hope you will agree that the improvement can be quite breathtaking.
Psoriasis is an inflammatory skin condition that causes thickening, redness and scaling. It can affect the whole of the skin including the scalp and nails. Occasional it can be associated with arthritis. It tends to be intermittent in nature and is characterized by remission and ‘flare ups’. The causes of psoriasis remain unknown but it can run in families and be precipitated by illnesses, stresses or even some medications. Although there is no cure, the condition can be well controlled with medication.
There are several clinical patterns of psoriasis (see pictures):
Chronic Plaque– The commonest variant, it tends to occur on the extensor aspects of the elbows and knees and in the scalp. Skin changes include pink or red inflamed, thickened plaques with copious white scale (see image).
Sebopsoriasis – similar to scalp psoriasis but can occur on the face, chest, armpits and groin
Flexural – raw, red areas in the groin, armpits or under the breasts
Guttate – multiple small spots of psoriasis that erupt on the trunk following a sore throat or illness (see image).
Erythrodermic – extensive disease covering more than 90% of the body surface area.
Palmoplantar pustular – pus-filled inflamed spots and the palms and soles
Pustular – the most severe form of psoriasis, skin lesions are red, tender and filled with pus spots
Psoriasis can vary in severity from no more than a minor irritation to being a major problem - in extreme cases, sometimes requiring hospitalisation. Even a small bit of psoriasis in a delicate area such as the face or genitals can cause immense distress. Occasionally it can be itchy or cause painful splitting or fissuring of the skin. As well as the skin being affected, the nails can become abnormally brittle with flaking and pitting. 5% of patients might develop arthritis associated with psoriasis.
The treatment of psoriasis can be divided into three basic strategies depending on severity, namely creams, phototherapy (ultraviolet/sunlight) or systemic medication (oral or injectable drugs).
Creams include emollients, soap substitutes, vitamin D, tar, steroids.
Phototherapy involves precise doses of ultraviolet light being delivered by a medical UV-machine. Phototherapy services are available through our clinic with trusted local providers such as the Phototherapy Clinic or the Whittington Hospital. Sessions may be 2 or 3 times weekly depending on the type of ultraviolet therapy required and the cost is between £100 - £180 per week approximately, again dependent on the type of therapy required.
Systemic medications include tablets such as acitretin, methotrexate and ciclosporin or injectables such as etanercept, adalimumab or ustekinemab. These powerful drugs are reserved for severe or life-limiting psoriasis. (For more information on psoriasis, please see the British Association of Dermatologists website treatment for moderate or severe psoriasis advice leaflet).
For more information on psoriasis, please see the British Association of Dermatologists website psoriasis advice leaflet.