Psoriasis is an immune-mediated skin disease, which can also affect the joints in some individuals. The prevalence of psoriasis in Western populations is estimated to be around 2-3%. It affects both sexes equally and occurs at all ages.

  • Psoriasis can be physically and psychosocially limiting. Depending on the severity and location of psoriasis outbreaks, individuals may also experience physical discomfort and disability. Itching and pain can interfere with self-care, walking, and sleep.
  • Psoriasis skin variants include plaque, pustular, guttate, erythrodermic and flexural psoriasis. Psoriasis can also involve or be limited to the scalp or nails. Plaques on the hands and feet can limit daily activities.
  • Psoriatic arthritis is most common in the joints of the fingers and toes but may also affect the hips, knees and spine (spondylitis). About 10-20% of people who have skin psoriasis also have psoriatic arthritis.

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Psorasis Puget Sound Dermatology
Psorasis Puget Sound Dermatology

Treatment For Psoriasis

  • Topical therapies for psoriasis includes moisturizers, corticosteroid creams, and ointments, zinc shampoo, salicylic acid lotions and shampoos, coal tar lotions and shampoos, anthralin, a vitamin D analog called calcipotriol and tazarotene cream, a topical retinoid.
  • Ultraviolet light therapy (NbUVB phototherapy) requires 2 to 3 sessions per week for a few months, followed by maintenance sessions 2 to 4 times per month to maintain clearance. This phototherapy can be combined with topical products (coal tar, calcipotriol, topical corticosteroids or topical retinoids) or systemic retinoids (acitretin) for faster results.
  • Oral therapies for psoriasis include methotrexate (taken weekly), acitretin (taken daily) and cyclosporine (taken daily and used mainly as a “bridge drug” to long-term therapies).
  • Newer injectable agents for psoriasis, also called biologic therapies are given by subcutaneous injection, infusion or intramuscular injection. The frequency of injection or infusion depends on the drug and the severity of the psoriasis.
  • With all systemic psoriasis drugs (whether oral or injectable) tuberculosis testing (PPD and chest X-ray) must be negative before beginning therapy. Some therapies also require other blood work and monitoring prior to and during therapy. 

    For more information visit the National Psoriasis Foundation website at

Meet Our Providers

Our providers continue to maintain the highest levels of accreditation and progressive ongoing education to learn and understand the latest developments in medical dermatology. Each provider's education and bio can be viewed below.


Melanie Kuechle, MD

Dr. Kuechle is a native of Texas and a graduate of Baylor University College of Medicine. She completed her dermatology residency at...


Dr. Craig Birkby

Dr. Birkby is Board Certified by the American Board of Dermatology and has performed over 15,000 Mohs surgeries...

Dr. Nguyen Sheena Puget Sound Dermatology

Sheena Nguyen, DO

Dr. Nguyen is a Fellow of the American Academy of Dermatology and a Board Certified, Fellowship-trained Pediatric Dermatologist. She was born and raised...


Ame Phitwong, ARNP

Ame is a board certified Adult-Gerontology Primary Care Nurse Practitioner who has worked entirely...