Question: I have had psoriasis for several years and it is getting worse. What is the cause, and what can I use to clear up my skin?

Dr. Hibberd's Answer:
Psoriasis is controllable, but no cure has yet been discovered. It is an inflammatory skin disease of unknown cause that is characterized by raised scaling skin lesions, especially over legs, arms, chest, and scalp.
It may be triggered by trauma, infection, and some medications. A destructive arthritis may develop on 5 percent to 30 percent of cases, and requires aggressive management.
Its treatment in its milder forms consists of topical corticosteroid preparations. If resistant, it is often combined with vitamin D analogs, retinoid preparations, and local tar preparations.
More involved forms are treated with topical Dovonex, or when arthritic damage or nail pitting is present, is usually treated more aggressively with methotrexate, immune suppressants and TNF (tumor necrosis factor) inhibitors. Often psoralen and ultraviolet treatment are added under dermatologist supervision.
There are a number of newer, expensive treatments for severe psoriasis. Drugs such as acitretin, alefacept, and efalizumab are very expensive but work very well to induce remission in severe cases.
Psoriasis is rarely a life-threatening condition, but it can significantly affect your quality of life if left untreated or incompletely treated. Have this condition treated into remission, and you will have a much better self-image. Your primary care physician can usually deal with mild cases. Dermatological consultation is advised for those with moderate or severe disease, or for those with arthritic damage or nail pitting.