Psoriasis
Psoriasis is a noncontagious, lifelong skin disease that may have periods of relative remission and flares (similar to asthma). As many as 1/50 patients have psoriasis. Higher risk for developing psoriasis is associated with a family history of the disease, use of systemic steroid medications, and high stress levels. Psoriasis can also occur after a strep infection.
The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. It is often itchy and may affect skin anywhere on the body, including the nails.
Psoriasis may also be associated with joint involvement, and this should be assessed during your visit. Psoriatic arthritis may lead to joint deformity if left untreated over time.
Treatment of psoriasis depends upon the extent and severity of your disease as well as the location of the plaques. Mild to moderate psoriasis can be treated with topical steroids, vitamin A-derived topical treatments, and preparations containing salicylic acid or coal tar. Moderate cases often respond to a combination of topical medications and narrowband UVB phototherapy (performed in our office under physician-supervised care).
Severe psoriasis and psoriatic arthritis may be treated with methotrexate, cyclosporine, or Soriatane®. Each of these drugs carries systemic risks, and they must be monitored with labwork. It is imperative that you obtain the necessary lab work to monitor these drugs, as liver damage, kidney damage, or even death can occur if not properly managed. Our staff provides limited prescriptions of these meds and will not refill them unless the lab work has been completed and is within normal limits.
Newer medications include the biologic medications such as Bimzelx®, Cimzia®, Cosentyx®, Enbrel®, Humira®, Ilumya®, Otezla®, Siliq®, Skyrizi®, Stelara®, Taltz®, and Tremfya®. These medications work to suppress very specific inflammatory mediators (rather than suppressing the entire immune system). They are either injections or intravenous medications. They are effective for both psoriatic skin disease and psoriatic arthritis.
Before Your Visit
Please be sure to bring a list of all medications and allergies. If you are covered by an insurance plan that requires prior authorization, the authorization or referral form must be presented to our office before or at the time of your appointment. It is your responsibility to obtain necessary referrals. If you don’t have one, we will ask you to sign a waiver stating you are responsible for the bill. Payment will then be expected at the time of service. Please bring your insurance cards to each visit so the information can be checked and a copy placed in your chart.
Financial Information
Your insurance coverage is an agreement between you and your insurance company. Financial responsibility rests with the patient for deductibles, co-insurances, and non-covered services. Insurance coverage is a variable, and we cannot guarantee what services will be covered by your particular plan. We request that you sign an authorization form, which will enable us to receive insurance payments directly when applicable. Co-payments are due at the time of service. For your convenience, we accept personal checks, Visa, MasterCard, Discover, American Express, and cash.
A no-show fee of $50.00 will be charged to patients who fail to appear for their appointment and provide less than 24 hours' notice of cancellation.
Pathology, Labs, and X-rays
Surgical specimens are sent to a laboratory for analysis. The fee for this is a separate charge from the office visit and may be billed directly by the processing lab. Results are usually available 7-10 days after the test has been performed. Questions regarding payments for laboratory services should be directed to the laboratory.
Prescription Refills
Prescription refill requests will be taken only during regular office hours.