I think it's very important that a patient with psoriasis sees somebody who has an interest in psoriasis, understands his or her disease, and knows how to treat it appropriately. Just going to a store and picking up a tube of cream and hoping that it's going to help their psoriasis is not really going to do very much. There are experts in the field of psoriasis, nationally and internationally, and I think it's very important that a psoriasis patient gets educated about his or her disease, learns what's going on, and then seeks out a professional that can be sympathetic, empathetic, and treat them accordingly.

When patients first come in to see us with their psoriasis, we discuss not only the physical attributes of psoriasis, what it looks like, is it itching, is it burning. We also talk about how it affects a patient emotionally.

So we try to go through how this impacts them on a day-to-day basis and it's interesting to me that when I ask that question, often, they say, “No one has ever asked me that question before,” and tears well up, because it affects them so significantly in different, different ways.

To manage psoriasis adequately I do believe you need a team approach. You need to bring the family into it, family needs to understand the disease in addition to the patient understanding, the staff who's treating their patient must be understanding, and it's got to be a collective understanding of the disease so that everybody is focused on the correct treatment not just for the short term but for the long term. I think it's very important to make patients comfortable with not only the disease but the treatment of the disease, so we do discuss all aspects of treatment, the different, four different varieties of treatment (creams and ointments, light treatment, oral medicines, injectable medicines). So it's vitally important that we educate them about all the pros and cons and I don't make the decision, I make the decision in concert with the patient.