For medical office visits, we are a cash-only practice. Our initial medical office visit is $250 and follow-up medical appointments are $130. Please feel free to contact us at the number listed below if you have any questions, or would like to schedule an appointment.

What exactly is psoriasis?

Psoriasis is a non-contagious chronic skin condition. It is not passed on to anyone through touch or exposure. The exact cause is unknown. Researchers contend  that psoriasis has both hereditary and environmental components and is mediated by the immune system. Normally, skin cells that are formed in the deepest layers of your skin make their way to the surface. Theses cells mature, are sloughed off the body’s surface, and are then replaced with new skin cells from beneath. This cycle takes approximately a month. In someone with psoriasis, however, once the immune system is accidentally activated, and an abnormally rapid skin cell cycle occurs. This means the cells move from the deepest layers of your skin to the surface in about four days instead of a month. Since the cells move to the surface so quickly, they don’t have time to properly mature. Instead, they accumulate on the skin’s surface, forming raised, red patches or “lesions.”

Psoriasis Symptoms

  • thick, raised red patches of skin covered with a dry, silvery white build-up of scales
  • patches can appear anywhere on the body.

While a doctor can diagnose psoriasis, it is typically done by a dermatologist – a physician who specializes in diagnosing and treating conditions that affect the skin.

Researchers believe that the disease may occur when your immune system (your natural protection against bacteria, viruses, and other foreign invaders) is accidentally activated, triggering an acceleration of the normal skin cell cycle. This in turn causes an accumulation of skin cells on the surface of the skin.

While no one knows what triggers this response, heredity plays a part in it. If you have one parent with psoriasis, you have a 25% chance of getting it too. If both your parents have it, your chances are more than 50%.

On the other hand, some people with no detectable family history have psoriasis. There are various environmental factors, such as stress, injury to the skin, etc. that can trigger psoriasis. For this reason, it is believed that both genetic and non-genetic factors may cause the disease.



Get your questions answered and find out which treatment is best for you by meeting with Dr. Pilest for an in-person consultation.


Types of Psoriasis

While plaque psoriasis is the most common type of psoriasis, the condition appears in a variety of forms that can occur on different parts of the body. Each has its own set of symptoms.

  • Plaque psoriasis (psoriasis vulgaris) appears as dry, scaly patches of skin and is the most common form of the disease
  • Guttate psoriasis emerges as small dots on the skin that start out pink in color and eventually become scaly
  • Inverse psoriasis appears as smooth, red lesions and is found primarily in the armpits, groin, and skin folds
  • Pustular psoriasis appears as small white, fluid-filled blisters that contain white blood cells
  • Palmo-plantar pustulosis is a localized type of pustular psoriasis that appears on hands and feet
  • Erythrodermic psoriasis develops over large areas of the body and the skin is red with excess shedding of fine scales
  • Scalp psoriasis appears on the scalp as red lesions covered with scales
  • Nail psoriasis can produce nail changes such as pitting, thickening, discoloration, and loosening of the nail from the nail bed

Psoriasis sufferers often develop a type of psoriasis known as psoriatic arthritis. This distinct condition occurs in from 7% to 42% of people with psoriasis. In addition to skin symptoms, you may also experience joint tenderness or swelling, although a few people have joint symptoms with no skin symptoms.

Localized therapies  (If Psoriasis affects 5% or less of your body skin surface)

Topicals: creams, lotions, and ointments that are applied to the surface of the skin

  • Over-the-counter topicals
  • Anthralin
  • Coal tar preparations
  • Keratolytics (salicylic acid)
  • Moisturizers
  • Prescription topicals
  • Topical retinoids (Tazarotene)
  • Topical steroids (corticosteroids)

Vitamin D analogs (calcipotriene)

Dermal Fillers Irvine

Dermal Filler Patient

*individual results may vary

Systemic Treatment and/or Phototherapies


  • Oral prescription medications
  • Cyclosporine
  • Methotrexate
  • Oral retinoids (acitretin)
  • Injectable systemic medications:
  • Biologic medicines
  • adalimumab
  • alefacept
  • efalizumab
  • etanercept
  • infliximab
  • Phototherapy: artificial ultraviolet light, or a combination of ultraviolet light and medications
  • UVB broadband and narrowband
  • PUVA (UVA + psoralen)
  • Laser treatments



We love our patients at Total Dermatology! Read what our satisfied patients have to say about their experiences with Dr. Pilest and our team.

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*Individual Results May Vary

Take the Next Step

Want to learn more about Restylane Kysse? Schedule your consultation with board-certified dermatologist Dr. Nissan Pilest at Total Dermatology in Irvine, CA today by calling (949) 408-1982.

*Individual Results May Vary