Somerset Skin Centre
255 Kirts Blvd, Suite 100
Troy, MI 48084

Phone: (248) 244-8448
Fax: (248) 244-8766

Office Hours

Monday - Friday 8:00 am - 5:00 pm. Evening appointments available

Saturday 8:00 am - 1:00 pm

Mohs appointments are available Monday through Friday and some Saturdays.

 

Psoriasis is a common skin disorder, affecting about 2% of the general population. It is an inflammatory disease in which individuals develop skin lesions on their body. Individuals may have only a limited amount of skin involved or the whole body may be affected. While psoriasis is not typically life threatening, it can greatly affect appearance, self-esteem, and quality of life. Psoriasis is often itchy and may cause painful drying, cracking or blistering. Up to 40% of individuals with moderate to severe psoriasis develop arthritis symptoms, or have psoriatic arthritis. Joint symptoms may develop before, at the same time, or after the onset of psoriasis. A number of treatment options are available for psoriasis. For limited disease, topical medications are the therapy of choice and include topical steroids, vitamin D3 (Dovanex), tazarotene, and anthraline. Topical immunomodulators (tacrolimus, pimecrolimus) work well for lesions on the face, armpits and groin (inverse psoriasis).

For more extensive disease, phototherapy, systemic agents, and biologic agents are available. Phototherapy include broad band ultraviolet B (UVB), narrow band UVB, and psoralen and UVA (PUVA). Based on efficacy and minimal long-term effects, we primarily use narrow band UVB in our practice. Patients typically need treatment 2-3 times per week and respond relatively quickly. For limited localized disease, topical paint PUVA or excimer laser can be used. itching with narrow band UVB, including dialysis patients. Systemic agents include methotrexate, cyclosporine, (apremilast ) Otezla, and (acitretin) Soriatane.These agents require close monitoring and are for patients with severe disease.

Recently several new agents are approved for the treatment of psoriatic arthritis and psoriasis. These agents, called biologics because they are protein medications that are injected or infused into patients, have an excellent safety profile and are highly efficacious. These biologics include etanercept (Enbrel) and adalimumab (Humira), which are TNF inhibitors; ustekinumab (Stelara), which is an IL-12 and IL-23 antagonist; and secukinumab (Cosentyx) and ixekizumab (Talz), which are IL-17 antagonists. Infliximab (Remicade) is approved for psoriatic arthritis and is given as an intravenous infusion in the doctors office. Infliximab acts by binding TNF-a. New biologics are on the horizon. Some patients with severe eczema or severe urticaria may benefit from Xolair, an IgE inhibitor. Dr. Murakawa at Somerset Skin Centre regularly utilizes all treatment options available. Some treatment options are required in the office setting and some may be administered at home. Somerset Skin Centre offers all therapeutic options, including phototherapy (narrow band UVB and PUVA), and biologics. The office staff is fully trained for infusions and intramuscular injections.

 

Dr. Murakawa is a member of more than ten professional dermatological organizations including the American Academy of Dermatology, the Association of Professors of Dermatology, Michigan Dermatological Society, American Society for Dermatologic Surgery, American Society for Mohs Surgery, the Dermatology Foundation, the Society of Investigative Dermatology, the American Medical Association, Michigan State Medical Society, and the Medical Dermatological Society.