Psoriasis Diagnosis and Treatment in London

Understanding psoriasis

Psoriasis is an immune-mediated condition that accelerates the life cycle of skin cells, causing a build-up of thickened, inflamed plaques. It can vary from small localised patches to widespread disease. Psoriasis is not only a skin disorder but can also affect nails and joints, contributing to psoriatic arthritis.

Psoriasis Symptoms

• Raised, red plaques with silvery-white scales
• Itching or burning sensations
• Dry, cracked skin that may bleed
• Nail pitting, thickening, or detachment
• Joint stiffness, swelling, or pain (psoriatic arthritis)

Types of psoriasis

• Plaque psoriasis: Most common type, with raised red plaques and scaling.
• Guttate psoriasis: Small, droplet-shaped lesions, often after throat infections.
• Pustular psoriasis: White pustules surrounded by red skin.
• Inverse psoriasis: Smooth red patches in skin folds.
• Erythrodermic psoriasis: Severe, widespread redness and scaling, a medical emergency.

Causes and triggers of Psoriasis

Psoriasis arises from a combination of genetics and immune system dysfunction. Common triggers include:

• Infections (e.g., strep throat)
• Stress and emotional strain
• Cold weather
• Skin injury (Koebner phenomenon)
• Certain medications (beta-blockers, lithium, antimalarials)
• Alcohol and smoking

Psoriasis Diagnosis

A dermatologist typically diagnoses psoriasis by examining the skin, nails, and scalp. In unclear cases, a small skin biopsy may be taken. Screening for psoriatic arthritis is also important, as up to 30% of patients develop joint involvement.

Psoriasis Treatment options

Treatment depends on severity, impact on quality of life, and associated health risks:

• Topical treatments: Corticosteroids, vitamin D analogues, coal tar, and salicylic acid creams.
• Phototherapy: Controlled ultraviolet light treatment.
• Systemic medications: Methotrexate, ciclosporin, acitretin for moderate to severe disease.
• Biologics: Advanced targeted injections for resistant or severe psoriasis (e.g., anti-TNF, anti-IL biologics).
• Lifestyle management: Stress reduction, balanced diet, avoiding triggers, smoking cessation.

Living with psoriasis

Psoriasis can affect mental health, self-confidence, and social interactions. Support groups, psychological care, and regular follow-up with dermatologists can improve wellbeing and quality of life.

Your first visit — what to expect

1. History: Medical history, symptom triggers, and family history of psoriasis.
2. Examination: Assessment of skin, scalp, nails, and joints.
3. Tests: Blood tests or biopsy if diagnosis is uncertain.
4. Treatment plan: Tailored therapy based on disease severity and lifestyle.
5. Follow-up: Monitoring for treatment effectiveness and long-term safety.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 22 August 2025