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Psoriasis Psoriasis Basics About Psoriasis The following is a list of questions to ask your doctor About Psoriasis  as well as tips for preparing for these conversations. What causes psoriasis? The exact cause of psoriasis is unknown, but it is believed that a trigger, such as emotional stress, skin injury, certain infections or a reaction to medication, may set off psoriasis for the first time in genetically susceptible people. Ordinarily, skin cells regenerate about every 28 days. But a malfunction in the immune system caused by a trigger elicits the release of substances that make the cells of the skin to multiply too quickly. This produces flaky, white raised patches that are red, itchy and sometimes burn. These lesions can appear anywhere on the body, but are more commonly found on the knees, elbows, scalp, hands, feet or lower back. It is not contagious. How you can prepare for this discussion Gather details of any past illnesses and health conditions and their treatment Note any skin injury Record the dosages and schedules of all the prescription, over-the-counter medications and dietary supplements you are taking < Find out if there are other family members with the disease What kind of psoriasis do I have? There are many forms of the disease but the majority of people have plaque psoriasis, which is marked by distinct red patches. Other types include guttate psoriasis, which involves smaller lesions that appear on the trunk and limbs, and inverse psoriasis, which usually appears as smooth, red, dry lesions in the folds of the armpits, groin, breasts, genitals and buttocks. Less common types include erythrodermic and pustular psoriasis. Some people may also have painful joints (psoriatic arthritis). Psoriasis is classified by the amount of skin affected, the location and severity of lesions, functional disability, disfigurement and emotional distress. How you can prepare for this discussion Keep a log of what worsens lesions and what make them better Note the location, pattern, color and other characteristics of all lesions What treatments are available for my type of psoriasis? Not all therapies work for everyone and sometimes it takes a period of trial-and-error to find the right treatment or combination of treatments. Treatment will depend on the severity and location of patches and your state of health, personal preferences and ability to manage the treatments. There are treatments that can induce remission and others that are good for controlling flare-ups. Some people will be able to manage symptoms with topical lotions, while others will require more intensive therapies. Treatments include topical creams, phototherapy, and system-wide treatments sometimes referred to as systemic therapies. Systemic therapies are generally reserved for people with moderate to severe forms of the disease, but people with milder disease who are disabled by their symptoms may also benefit from these treatments. Systemic treatments for psoriasis include biologics (Amevive, Enbrel, Raptiva, Remicade), cyclosporine, methotrexate and oral retinoids. How you can prepare for this discussion List any drug allergies Consider any personal lifestyle habits or work-related activities that may be affected by complicated therapy schedules Make a list of all prescription, over-the-counter medications and dietary supplements you are taking now or in the past What can I expect from my treatment? While there is no cure for psoriasis, long-term treatment can keep the disease under control for most people. The goal of psoriasis therapy is to control the number and severity of lesions, minimize flare-ups, improve quality of life, maintain long-term remission, and reduce disability. Side effects of treatments will vary and some treatments can only be given for a limited time. Remission can occur naturally in some individuals, while others will need ongoing therapy to offer varying degrees of disease-free periods. How you can prepare for this discussion Tell your doctor if you have had any problems remembering to take medications in the past Let your doctor know about your support network and ability to keep scheduled appointments What factors influence remission and flare-ups? Psoriasis is unpredictable and people can experience relapses naturally, during treatment and following treatment. Some people with severe forms of the disease may notice the disease creeping back shortly after treatment ends, while others may enjoy monthly and occasionally years of treatment-free periods. Continuous therapy, repeated courses of therapy, or a combination of therapies can extend periods of remission in many people. People who are prone to disease flare-ups are encouraged to keep track of disease flares in an effort to identify possible triggers, such as diet, stress, weather, other medications or allergies. How you can prepare for this discussion Note all past and current medical problems List your experience with other skin therapies Keep a diary indicating how you feel when beginning a new medication Keep a symptom diary so you can identify triggers < RELATED PROGRAMS Video - Treatment Options for Psoriatic Arthritis Transcript Video - Childhood Psoriasis: What Parents and Caregivers Need to Know Transcript Video - Combination Therapy in the Treatment of Psoriasis Transcript Video - Understanding Psoriasis Transcript Video - Living With Psoriasis: Quality of Life On Treatment Transcript Video - What is Remission in Psoriasis? 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