Chronic Plaque Psoriasis

Chronic plaque psoriasis is the most common form of psoriasis.  Often seen on elbows, knees, lower backs and the umbilicus, this form of psoriasis presents as red, flat areas with thick silvery scale.  Severity may vary, ranging from isolated plaques to extensive areas of involvement.

  • May be accompanied by scalp and nail psoriasis.
  • Patients may have isolated plaques on their elbows, and/or large sections of their bodies.
  • Plaques may remain stable or gradually progress to larger areas if left untreated

It is sometimes mistaken for tinea or thicker forms of dermatitis.

Even though many patients may have no symptoms, some patients may develop considerable itch or pain, especially when larger areas are involved.

Psoriasis often runs in families.  Severity may vary, and while some family members may just have mild nail changes or scalp scaling, others may have large areas of plaque psoriasis.

If you have a genetic predisposition to developing psoriasis, other factors such as stress, irritants and allergens, drugs and medication, trauma, diet and infection may flare or deteriorate it at any time.

There are many myths surrounding the causes and treatments of psoriasis.

Addressing the trigger factors for psoriasis forms the foundation of a psoriasis free treatment plan. Most patients will have at least one or two trigger factors.

The most common triggers include-

  • Infection
  • Stress
  • Medications
  • Foods
  • Alcohol and smoking

Patients with chronic plaque psoriasis may develop psoriatic arthritis, which may cause permanent damage to joints if not treated early.

Chronic plaque psoriasis, especially large plaque psoriasis, is associated with a group of conditions known as metabolic syndrome (obesity, diabetes, increased cholesterol and high blood pressure).  There is also an increased risk of heart disease and strokes, lymphoma, inflammatory bowel disease, depression and alcohol consumption.

It is important to screen for these conditions and manage them in patients with psoriasis.

The Psoriasis Institute  has multidisciplinary specialists who can identify your associated risk factors and organise tests and management plans.  These specialists include dermatologists, rheumatologists, cardiologists, psychiatrists and dieticians.

The Psoriasis Institute in Brisbane comprises of specialist nurse practitioners, dermatologists, rheumatologists, cardiologists, psychiatrists and dieticians who can work together to address all the issues associated with psoriasis for you.

Treatments for your psoriasis include:

Identifying and avoiding triggers

Our team can help you identify and treat your triggers including allergies, irritants, stress and trauma.

Screening for associations

Our multidisciplinary specialist team will screen you for diseases associated with psoriasis, organise the required tests and organise management plans and treatment.


In early or limited plaque psoriasis, creams may work very well.  Steroids, vitamin D and A, tar and dithranol creams may be prescribed in combination to you by our specialists for this stage of psoriasis.

Narrowband UVB phototherapy

"Light treatment" is one of the best ways to treat chronic plaque psoriasis. Combined with creams or tablets, psoriasis may start to improve over a few days. This treatment can reduce the need for steroid creams. Phototherapy treatments are bulk-billed, and take no longer than 2-3 minutes to perform.


Tablets are used in resistant or severe psoriasis, or if psoriasis is involving the joints.   The most commonly used agents are methotrexate, cyclosporine and acitretin.  These are generally prescribed by a specialist and will need monitoring and regular blood tests.

Biologic injections

This form of treatment is reserved for patients who have severe psoriasis and have failed most other treatments.  At the Psoriasis Institute, dermatologists with a special interest in biologic therapies will assess and treat you if you qualify for these drugs.

Some cases of psoriasis respond well to a carefully prescribed diet, formulated by a dietician specialised in psoriasis management. The few cases of psoriasis associated with gluten intolerance responds extremely well to dietary control. Psoriasis affecting the skin folds, known as flexural psoriasis can respond well to a calorie controlled diet.

Eating well, and supplementation with vitamins can help. Eating foods high in anti-oxidants, bioflavinoids, and omega 3 fatty acids forms the basis of a psoriasis diet.

For more information on diet and psoriasis, book in to see our dietician, Valerie Young.

Apart from having a healthy, balanced diet and keeping fit, using a soap free wash and regular moisturisers are important long-term aspects in maintaining control of your psoriasis.  Our experts will give you recommendations based upon your psoriasis type and skin sensitivities.

The Psoriasis Institute was developed for the treatment of all forms of psoriasis ranging from mild scalp disease through to severe forms of psoriasis. Our multidisciplinary team of nurses, Dermatologists, Rheumatologists, Cardiologists and dieticians ensure that we cover all aspects of this disease. Using state of the art phototherapy units, PBS listed medications and natural vitamins, we give psoriasis patients their choice of treatments.

No matter what type of psoriasis you may have, The Psoriasis Institute will find a solution.

No referrals are needed to visit us. Your first visit involves seeing a specialist psoriasis assessor. This appointment takes 20-30 minutes, and is partially covered by Medicare.

All treatments such as phototherapy are bulk billed. Most medications are on the PBS, so prescription creams and tablets range from $16 to $35.

Chronic plaque psoriasis, especially when involving larger or cosmetically sensitive areas, can greatly affect patients not just physically but also psychologically.    Patients may withdraw from social settings, have problems forming relationships and may also suffer discrimination at work.

Furthermore, with our more recent understanding of metabolic syndrome, it has become obvious that psoriasis may be associated with a number of other organ disorders.

Treating chronic plaque psoriasis thus first requires a thorough understanding of these associations and assessing these risk factors.  Following this, a treatment plan to address not just the skin but also other physical and psychological factors may be formulated.

Your multidisciplinary specialist team at the Psoriasis Institute are best placed to guide you through this process so that you receive the optimal long-term management for your condition.

Dr Shobhan Manoharan -  Consultant Dermatologist


  • I can get an extra dose of phototherapy on Saturdays at the Institute, this really helps as I am at work during the week.
    - Mitch D. Sherwood

Psoriasis ranging from mild to severe can be readily treated by The Psoriasis Institute