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Feature:
Living with Psoriasis

An Expert's Advice: What To Do If You Have Psoriasis

Dr. Joel M. Gelfand

Dr. Joel M. Gelfand, M.D., M.S.C.E., is Associate Professor of Dermatology and Epidemiology, Senior Scholar Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine.
Photo courtesy of Penn Medicine/Addison Geary

Joel M. Gelfand, M.D., M.S.C.E., focuses on psoriasis and how it can lead to various conditions, such as heart disease, diabetes, and obesity. His research has been funded in part by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Heart, Lung, and Blood Institute (NHLBI), the National Psoriasis Foundation, the Dermatology Foundation, and the American Skin Association.

What is psoriasis?

Psoriasis is a chronic (long-term) inflammatory skin disease for which there is no cure at this time. Depending on the severity, psoriasis patients also are at increasing risk for other diseases affecting the lungs, heart, kidneys, liver, and pancreas. These include cardiovascular disease, obesity, diabetes, and other serious illnesses.

What do you recommend for people with psoriasis?

Patients and their doctors should beware of the higher odds psoriasis holds for other serious illnesses, especially in severe cases. Patients should get regular checkups, including testing for cholesterol, blood sugar and lipids (fats in the blood), and urine analysis. They should exercise regularly, keep their BMI (body mass index) below 25, and eat a healthy diet. If they smoke, they should quit. There are many treatments for psoriasis and, therefore, patients should consult a dermatologist (skin specialist) for the most appropriate treatment, especially if the diagnosis is uncertain or is not responding well to treatment.

Is there a preferred treatment for psoriasis?

In a recent survey of ours, dermatologist members of the American Academy of Dermatology and the National Psoriasis Foundation reported they prefer treating patients with ultraviolet light. Unfortunately, most patients find this treatment too expensive to continue for very long. We have to make it more accessible and more affordable. Dermatologists also prefer traditional oral medications for psoriasis, such as methotrexate and newer biologic medications.

What are your research goals?

We always want to learn more, especially with such a complicated disease as psoriasis. The challenge is to develop effective, long-term treatments that have minimal side effects. Our priority is to improve psoriasis patient outcomes in the skin and joints, while lowering the risk of diabetes, cardiovascular disease, and mortality.

What new treatments are on the horizon?

The short-term future looks very positive, thanks to our growing understanding of how psoriasis works. In particular, we are looking at targeted, injectable, and oral medications.

Read More "Living With Psoriasis" Articles

I Live With Psoriasis / What Is Psoriasis / How is Psoriasis Treated? / An Expert's Advice: What To Do If You Have Psoriasis

Fall 2013 Issue: Volume 8 Number 3 Page 27