Psoriasis
Psoriasis is a chronic immune-mediated skin condition, managed per the Joint AAD-NPF Guidelines of Care (2019-2021).
Symptoms
Well-defined, red plaques with silvery-white scale, most often on the elbows, knees, scalp, and lower back; nail pitting and joint pain (psoriatic arthritis, affecting 5-20% of patients) can accompany skin symptoms.
Causes and risk
An overactive immune response drives rapid skin cell turnover; genetics, infections (strep throat can trigger guttate psoriasis), stress, and certain medications can trigger or worsen flares.
How it is evaluated
Diagnosis is clinical based on the characteristic plaques; body surface area affected determines whether disease is classified as mild, moderate, or severe, which guides treatment intensity.
Treatment
Topical therapy suits mild disease. Biologics (grouped by target: TNF-alpha, IL-12/23, IL-17, IL-23 inhibitors) are a first-line option for moderate-to-severe plaque psoriasis per AAD-NPF guidance, alongside older systemic non-biologic options and phototherapy.
When to seek care
Widespread pustules or skin turning red and peeling over the whole body (erythrodermic or generalized pustular psoriasis) is a dermatologic emergency with real mortality risk, per National Psoriasis Foundation emergency guidance -- this needs immediate care, not a routine follow-up.