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Commonly affecting 2% of Americans, the skin condition known as psoriasis is a long-term condition that appears as white or silvery patches on the skin. It can be embarrassing to patients, especially in situations when they have exposed skin. Dr. Matsuda, Dr. Sheu, and Dr. Jim On in Honolulu, HI can provide professional advice to patients suffering from the condition.


This skin condition is characterized by plaques of scales on the skin. This is due to the abnormal rapid proliferation of skin cells caused by the overreacting of the immune system. The symptoms are commonly found on the skin of the scalp, elbows, and knees. It can range from mild psoriasis, which is characterized as faint patches of dry skin, to severe, wherein virtually the entire body is full of the thick, red skin.


Aside from the silvery, white flakes or red patches on the skin, this skin disorder can also be associated with arthritis. Psoriatic arthritis manifests as joint pain, stiffness, or swelling in any part of the body.

When on moist areas such as the navel or between one’s buttocks, psoriasis patches may appear flat and red, which can be easily confused with skin irritation or other skin disorder. It can also be found in the genitals, commonly around the head of the penis.

When on fingers and toenails, psoriasis may manifest as pinpoint depressions, which are called pits, or large separations on the nail bed, which are called oil spots. On the scalp, it is commonly mistaken as dandruff.


This skin disorder is controlled by the immune system, particularly involving the T-cell – a white blood cell type. Normally, the purpose of the T-cell is to protect the body from infection against foreign bodies, preventing the occurrence of disease. However, in the case of psoriasis, these T-cells become so active by mistake that they activate the body’s other immune responses. They are responsible for the inflammation and the rapid proliferation of new skin cells.


It might seem like a harmless skin condition, but psoriasis actually affects daily life in a significant way. The symptoms may cause physical discomfort and disability to the patient with the disorder. The itchy and painful scales on the skin could affect daily activities such as walking, self-care, and even sleeping. Furthermore, the plaques that grow on the patient’s hands may hinder the individual to work in certain occupations or even care for the family at home. In addition to the physical effects of the disease, the patient may feel depressed and isolated, and even fear public rejection.


Health-care professionals confirm the presence of psoriasis through an initial physical examination, obtaining relevant family history, and at times, a skin biopsy and X-ray may be essential.


Based on the severity and condition of the disease, doctors suggest treatment for the disorder in a variety of steps. Because reaction to medication varies from patient to patient, and since the affected skin may become resistant over time, doctors usually suggest a trial-and-error approach to find out which treatment really works for the individual.

Topical treatment. The following will most likely be prescribed by your dermatologist:

  • Topical corticosteroids
  • Retinoids
  • Vitamin D analogs
  • Coal tar
  • Anthralin
  • Salicylic acid
  • Lubricants
  • Bath solutions

Light therapy. The controlled delivery of synthetic UV light may be effective in the treatment of psoriasis. This will be administered by a professional since too much exposure to heat may worsen the disorder, so strict control should be performed. It can be administered through exposing the patient to direct sunlight, ultraviolet B phototherapy, or psoralen and ultraviolet A phototherapy.

Systemic treatment. In severe cases of psoriasis, medicines that should be taken internally can be suggested. Treatment includes methotrexate, retinoids, cyclosporine, and biologic response modifiers.

In certain cases, depending on the development of the condition to the treatments used, your doctor may suggest a combination therapy of all the approaches mentioned above.


Matsuda Dermatology
405 N Kuakini St., Suite 703
Honolulu, HI 96817
Phone: 808-818-8937
Fax: (808) 941-3112

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