Psoriasis – Yale Medicine Explains

Psoriasis – Yale Medicine Explains


– Psoriasis is a type of inflammation that happens in the skin
where the immune system goes from doing what it’s supposed to do which is fight off infection, and instead turns against
the skin cells at themselves. What this results in
are spots that are red, and scaly on different parts of the body. Sometimes patients come and
they have been diagnosed with eczema or fungal infections, But in fact, when they see a physician who’s skilled in understanding
the cutaneous signs of psoriasis, we can
actually quite rapidly make the diagnosis. For example we know that
psoriasis will frequently appear symmetrically on both
elbows or both knees. And then it also as a
predilection for the buttocks. Although it can also affect the scalp, and even the entire body in people who are severely affected. When it comes to causes of psoriasis, everyone wants to know whether
it’s something they did, and our answer is consistently no. In fact, our understanding of psoriasis is really evolving. We now know that there are some people who have genetic factors
that run in their families, but that there is also likely
an environmental influence. When it comes to thinking about treatments for psoriasis, it’s really individualized on a patient by patient basis. So if someone has just a
little bit of psoriasis, we can frequently treat
it with simple creams that people put on at bedtime. But as the amount of psoriasis increases or if it’s in special
locations like on the scalp or in the genital area,
we can move from creams to something called phototherapy
which is medical sunlight. And then for cases that are more severe, we consider things that you take by mouth, and newer very targeted therapies frequently called biologic therapies. These are specifically targeting molecules that are involved in the
psoriasis inflammation. It can go in and essentially suck up these extra inflammatory molecules, and we can completely
eradicate skin psoriasis. And also improve the joints, and potentially reduce the
risk of cardiovascular disease in patients with psoriasis as well. At Yale Medicine we try to come up with an individualized treatment
plan for every patient. And I think about one person in particular who came to me, and there
wasn’t a single square inch on this individual’s body
that wasn’t affected. He was itchy, he was red, he was scaly. He told me that he had to
carry a vacuum with him so that he could vacuum
up the scale everywhere that he went. We decided upon a
combination of two things. An oral agent in one of these
newer biologic therapies. And it was really wonderful to see him come back a few weeks
later, seeing a break in his psoriasis, and then a month later coming in and being entirely clear. I am Doctor Keith Choate
from the Department of Dermatology at Yale Medicine.

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