Understanding Psoriasis: A Patient's Guide
Understanding Psoriasis: A Patient's Guide
- posted: Dec. 19, 2025
Psoriasis is a relatively common skin condition that affects millions of people. If you've been diagnosed or suspect you might have it, you're not alone. Here's a clear, straightforward overview to help you understand what it is, how it impacts daily life, and the treatment options available.
What Is Psoriasis?
- A chronic autoimmune condition: Your immune system mistakenly speeds up skin cell growth, causing cells to build up rapidly on the surface.
- Common types:
- Plaque psoriasis (most frequent): Raised, red patches covered with silvery-white scales, often on elbows, knees, scalp, and lower back.
- Nail: Marked by numerois small pits on the surface, uyellowish-brown discoloration resembling oil drops underneath the nail plate, thickening with some subungual debris, longitudinal ridges, and an overall appearance of onychomycosis, nail fungus.
- Guttate: Small, dot-like spots, sometimes triggered by infections.
- Inverse: Smooth red patches in skin folds like underarms or groin.
- Pustular: White pustules surrounded by red skin, usually on hands or feet.
Generalized **pustular psoriasis** is also very serious and can be life-threatening in some cases, but erythrodermic is widely regarded as one of the most dangerous due to its systemic impact. 
- Erythrodermic: Widespread redness and shedding (rare but serious).
The most serious type is **erythrodermic psoriasis** This rare form causes widespread redness and scaling over most of the body (often >90%), leading to severe complications like dehydration, infection, temperature dysregulation, protein loss, heart failure, or even life-threatening issues requiring hospitalization. 
Of note: it is not contagious: You can't catch it from someone else or pass it on...
Triggers
Can include: stress, binge drinking, infections, cold weather, certain medications, skin injury and poor diet.
How Psoriasis Affects Daily Life
- Physical symptoms: Itching, burning, soreness, cracked skin that may bleed, and thickened nails.
-Psychosocial impact:
- Many patients feel self-conscious about visible patches, leading to lower self-esteem.
- Can affect clothing choices, social activities, or intimacy.
- Higher rates of anxiety and depression compared to the general population.
- Sleep disturbances from discomfort or itching.
-Associated health concerns: Increased risk for psoriatic arthritis (joint pain and swelling), cardiovascular issues, and metabolic conditions.
Treatment Options
Once a diagnosis is confirmed, perhaps by history or biopsy then a treatment plan can be made.
Treatment is tailored to each person based on severity, location, involvement of joints or not and how it affects quality of life. Options include:
- Topical therapies (first-line for mild cases):
Corticosteroids to reduce inflammation.
Vitamin D analogs (like calcipotriene) to slow skin growth.
Retinoids, coal tar, or salicylic acid.
- Phototherapy: Controlled UV light exposure in a medical setting.
- Systemic medications (for moderate to severe cases):
- Oral drugs like methotrexate, cyclosporine, or acitretin are now not used as frequently as their are newer more safe options known as biologics outlined below.
- Biologics (injections): Target specific immune pathways (e.g., TNF inhibitors, IL-17 or IL-23 blockers) with excellent results for many.
- Common examples include:
- TNF inhibitors: Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab), Cimzia (certolizumab pegol)
- IL-12/23 inhibitor: Stelara (ustekinumab)
- IL-17 inhibitors: Cosentyx (secukinumab), Taltz (ixekizumab), Siliq (brodalumab), Bimzelx (bimekizumab)
- IL-23 inhibitors: Tremfya (guselkumab), Skyrizi (risankizumab-rzaa), Ilumya (tildrakizumab-asmn)
Choosing a biologic is an important decision that rests between you and your physician, outlining the benefits verses risks as well as the individual history of each person.
Part of the discussion includes outlining lifestyle support, such as moisturizing daily, managing stress, avoiding triggers such as binge drinking alcohol, and maintaining a healthy weight.
Most patients achieve good control with the right combination.
Every patient's psoriasis is unique, so individualized evaluation and treatment plans make a big difference. At Nashville Dermatology Physicians, located in Brentwood, TN and serving the greater Nashville area,
Dr. Jeffrey Berti and Dr. Toula Berti have years of experience successfully treating psoriasis and a wide range of other skin conditions. Having extensive knowledge in psoriasis as well as the options available for treatment is important, especially as the medicine and science regarding psoriasis is evolving.
We take time to listen, examine, and create a plan that fits your life and goals, as
Your Skin Health is our Priority!
Location:
1001 Health Park Dr., Suite 470
Brentwood, TN 37027
Phone: 615-212-2517
Website: nashvilledermatologyphysicians.com
If you're dealing with psoriasis or have questions, reach out—we're here to help you feel comfortable in your skin again.
Understanding Psoriasis: A Patient's Guide
- posted: Dec. 19, 2025
Psoriasis is a relatively common skin condition that affects millions of people. If you've been diagnosed or suspect you might have it, you're not alone. Here's a clear, straightforward overview to help you understand what it is, how it impacts daily life, and the treatment options available.
What Is Psoriasis?
- A chronic autoimmune condition: Your immune system mistakenly speeds up skin cell growth, causing cells to build up rapidly on the surface.
- Common types:
- Plaque psoriasis (most frequent): Raised, red patches covered with silvery-white scales, often on elbows, knees, scalp, and lower back.
- Nail: Marked by numerois small pits on the surface, uyellowish-brown discoloration resembling oil drops underneath the nail plate, thickening with some subungual debris, longitudinal ridges, and an overall appearance of onychomycosis, nail fungus.
- Guttate: Small, dot-like spots, sometimes triggered by infections.
- Inverse: Smooth red patches in skin folds like underarms or groin.
- Pustular: White pustules surrounded by red skin, usually on hands or feet.
Generalized **pustular psoriasis** is also very serious and can be life-threatening in some cases, but erythrodermic is widely regarded as one of the most dangerous due to its systemic impact.
- Erythrodermic: Widespread redness and shedding (rare but serious).
The most serious type is **erythrodermic psoriasis** This rare form causes widespread redness and scaling over most of the body (often >90%), leading to severe complications like dehydration, infection, temperature dysregulation, protein loss, heart failure, or even life-threatening issues requiring hospitalization.
Of note: it is not contagious: You can't catch it from someone else or pass it on...
Triggers
Can include: stress, binge drinking, infections, cold weather, certain medications, skin injury and poor diet.
How Psoriasis Affects Daily Life
- Physical symptoms: Itching, burning, soreness, cracked skin that may bleed, and thickened nails.
-Psychosocial impact:
- Many patients feel self-conscious about visible patches, leading to lower self-esteem.
- Can affect clothing choices, social activities, or intimacy.
- Higher rates of anxiety and depression compared to the general population.
- Sleep disturbances from discomfort or itching.
-Associated health concerns: Increased risk for psoriatic arthritis (joint pain and swelling), cardiovascular issues, and metabolic conditions.
Treatment Options
Once a diagnosis is confirmed, perhaps by history or biopsy then a treatment plan can be made.
Treatment is tailored to each person based on severity, location, involvement of joints or not and how it affects quality of life. Options include:
- Topical therapies (first-line for mild cases):
Corticosteroids to reduce inflammation.
Vitamin D analogs (like calcipotriene) to slow skin growth.
Retinoids, coal tar, or salicylic acid.
- Phototherapy: Controlled UV light exposure in a medical setting.
- Systemic medications (for moderate to severe cases):
- Oral drugs like methotrexate, cyclosporine, or acitretin are now not used as frequently as their are newer more safe options known as biologics outlined below.
- Biologics (injections): Target specific immune pathways (e.g., TNF inhibitors, IL-17 or IL-23 blockers) with excellent results for many.
- Common examples include:
- TNF inhibitors: Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab), Cimzia (certolizumab pegol)
- IL-12/23 inhibitor: Stelara (ustekinumab)
- IL-17 inhibitors: Cosentyx (secukinumab), Taltz (ixekizumab), Siliq (brodalumab), Bimzelx (bimekizumab)
- IL-23 inhibitors: Tremfya (guselkumab), Skyrizi (risankizumab-rzaa), Ilumya (tildrakizumab-asmn)
Choosing a biologic is an important decision that rests between you and your physician, outlining the benefits verses risks as well as the individual history of each person.
Part of the discussion includes outlining lifestyle support, such as moisturizing daily, managing stress, avoiding triggers such as binge drinking alcohol, and maintaining a healthy weight.
Most patients achieve good control with the right combination.
Every patient's psoriasis is unique, so individualized evaluation and treatment plans make a big difference. At Nashville Dermatology Physicians, located in Brentwood, TN and serving the greater Nashville area,
Dr. Jeffrey Berti and Dr. Toula Berti have years of experience successfully treating psoriasis and a wide range of other skin conditions. Having extensive knowledge in psoriasis as well as the options available for treatment is important, especially as the medicine and science regarding psoriasis is evolving.
We take time to listen, examine, and create a plan that fits your life and goals, as
Your Skin Health is our Priority!
Location:
1001 Health Park Dr., Suite 470
Brentwood, TN 37027
Phone: 615-212-2517
Website: nashvilledermatologyphysicians.com
If you're dealing with psoriasis or have questions, reach out—we're here to help you feel comfortable in your skin again.
Nashville Dermatology Physicians
1001 Health Park Drive Suite 470,
Brentwood, TN 37027
Monday
7:00 am - 4:00 pm
Tuesday
7:00 am - 4:00 pm
Wednesday
7:00 am - 4:00 pm
Thursday
11:00 am - 6:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed