Psoriasis

Psoriasis occurs when the body’s immune system becomes overactive and mistakenly attacks healthy skin cells. In response, the skin tries to repair itself more quickly than usual, causing a buildup of excess skin cells. These skin cells form raised plaques that are often covered in silvery scales. The condition is considered chronic, meaning it tends to persist long-term, often with cycles of flare-ups and remissions.

There are several types of psoriasis, with the most common being plaque psoriasis, accounting for about 80% to 90% of cases. Other forms include guttate psoriasis, pustular psoriasis, inverse psoriasis, and erythrodermic psoriasis, which is rare but can be life-threatening. Psoriasis can also affect the joints, a condition known as psoriatic arthritis.

The exact cause of psoriasis is not fully understood, but it is believed to be triggered by a combination of genetic and environmental factors. A family history of psoriasis significantly increases the risk of developing the condition. Immune system dysfunction plays a central role, particularly the involvement of T cells, which are white blood cells that normally protect the body from infection. In people with psoriasis, T cells become overactive, triggering an inflammatory response that speeds up the production of new skin cells.

Several factors may trigger or worsen psoriasis in those who are genetically predisposed:

• Stress: Emotional or physical stress can provoke flare-ups.
• Infections: Streptococcal throat infections are known to trigger guttate psoriasis, especially in children and young adults.
• Cold weather: Dry, cold climates may aggravate the condition.
• Skin trauma: Cuts, scrapes, or sunburn can lead to the development of new psoriatic lesions, a response known as the Koebner phenomenon.
• Certain medications: Beta-blockers, lithium, and antimalarials have been linked to worsening psoriasis.
• Alcohol and smoking: These lifestyle factors may increase the severity of symptoms.

Psoriasis symptoms can vary depending on the type and severity of the condition. Common signs include:

• Raised, red patches of skin covered with a silvery-white buildup of dead skin cells (scales)
• Itching, burning, or soreness around affected areas
• Dry, cracked skin that may bleed
• Thickened or ridged fingernails and toenails
• Stiff or swollen joints in cases involving psoriatic arthritis

The patches typically appear on the scalp, elbows, knees, lower back, chest, abdomen and buttocks, but they can develop anywhere on the body including the nails, genitals, feet, palms and face. Some individuals experience only mild patches, while others may have extensive involvement that interferes with daily activities.

Dr. Hibler will perform a detailed examination of the skin, nails, and scalp and takes a comprehensive medical history. In most cases, a visual inspection is sufficient for diagnosis. However, if the presentation is atypical, a skin biopsy may be performed to confirm the diagnosis and rule out other conditions such as eczema or fungal infections.

Dr. Hibler also evaluates for potential joint symptoms, as early detection of psoriatic arthritis is crucial for preventing joint damage. In the case of psoriatic arthritis, consultation with a rheumatologist may help confirm the diagnosis and guide treatment plans.

Because it is a lifelong condition, education, lifestyle adjustments, and emotional support are essential components of care. Dr. Hibler works closely with each patient to help identify and avoid personal triggers, establish a consistent skincare regimen, and monitor for any complications. With proper care, most people with psoriasis can achieve clearer skin and a better quality of life.