What does it look like?
The most typical appearances are red circles with white silvery dry scaling. One common type is guttate psoriasis, often triggered by a sore throat that produces lots of small round red scaly plaques on the body and limbs. Chronic plaque psoriasis is also common. Red circular dry plaques often appear on elbows and knees but the whole body can be affected.

Why does it happen?
Over 75 variations in genes have been found to contribute to psoriasis. Most patients will only have a few affected genes. They mainly affect genes in the skin's immune system, which makes the immune system in the skin overactive. Environmental triggers such as a sore throat infection can cause unwanted inflammation. Once this happens, the immune system then builds a memory for making psoriasis inflammation, so the problem recurs more easily and, in some cases, gets worse over time. Lifestyle factors such as smoking, alcohol and being overweight all contribute to inflammation in the skin and can worsen psoriasis.

Treatment options
There are five levels of treatment available for psoriasis.

1. Environmental factors that promote inflammation worsen psoriasis - stopping smoking, losing weight and minimising alcohol consumption can help your psoriasis. These three things are significant causes of inflammation in the body, which is why they are also linked to cancer, dementia and to inflammatory skin diseases.
2. There are a variety of creams available to treat psoriasis. These include moisturisers, steroid creams, tar-based creams and vitamin D creams. Some products such as Dovobet or Enstilar foam contain a combination of topical steroid and calcipotriol (vitamin D-like medicine). Creams are helpful for mild psoriasis but can be hard to apply if large areas of skin are affected.
3. If creams do not work, the next step is often various forms of light or UV therapy. These are often only available in NHS facilities, not as a private treatment. The UV light treatments (phototherapy) in Newcastle are based at the NHS Royal Victoria Infirmary and unavailable for private treatment. They can only be accessed if you are referred to NHS Dermatology by your GP. A Dermatologist in a private clinic in Newcastle will not be able to book you in for phototherapy.
4. Standard systemic therapies are a group of relatively established tablets or injections used for many years to reat psoriasis. These include metholtrexate, acitretin and ciclosporin. Some insurance companies will fund access to these treatments but often will not support long-term monitoring. For self-paying patients, the blood tests can be costly and the drug costs can also be expensive (remember that the actual price of medications is often much higher than an NHS prescription charge: with a private prescription you pay the full cost of the medication).
5. Biologic therapies and small molecules. These are a group of newer and generally more expensive medications. They are usually not funded by insurance in the UK and are very expensive if self-paying. The Newcastle Skin Partnership does not supervise these drugs. To access them in Newcastle you would need to be referred into the NHS Dermatology service. Patients can only use these medications if they have tried standard therapy and if their psoriasis is severe enough. Skin scoring is done to see if the PASI (psoriasis area and severity index) is above 10.