Plaque psoriasis is a common and incurable chronic immune-mediated skin disease characterized by red and flaky patches that are itchy and can be painful during flareups which can last for several weeks to months (Mayo Clinic, 2020). It is the most common form of psoriasis, affecting between 80% and 90% of individuals living with psoriasis, and can occur on any area of the body such as the scalp, hands, and feet (National Psoriasis Foundation, 2018). The disease rarely is life threatening but often is intractable to treatment, with relapses occurring in most patients.
Several risk factors for developing psoriasis and its severity have been identified and can be intrinsic (i.e., family history, stress) or extrinsic (i.e., smoking). Comorbidities associated with plaque psoriasis patients include depression, cardiovascular disease, inflammatory bowel disease, and psoriatic arthritis.
Disease severity is defined by the percentage of the body affected by plaques, with mild disease having less than 3%, moderate disease 3-10% and severe > 10% of the body affected. However, hard to treat plaques can occur in all patients.
Many treatments exist for psoriasis. Three basic treatment modalities are available for the overall management of psoriasis: topical agents; phototherapy; and systemic agents, including biologic therapies. Plaque psoriasis appears to respond better to combination topical/systemic therapy than to systemic treatment alone.