My name is Lawrence Gibson, M.D., and I'm a staff dermatologist at the Mayo Clinic in Rochester, Minnesota. There are several things that are very important for a patient to share with their doctor in order to get the best treatment possible for their psoriasis. For example, the conversation might start with, "How long have you had psoriasis? Does psoriasis run in your family? How much does psoriasis interfere with your life; for example, your work, your school or your interpersonal relationships?" All of these are very important for your doctor to know right up front and early on in your relationship.
In addition, other things that might be important to discuss are prior treatments. For example, were there topical creams and ointments used? Was phototherapy used? Were systemic medications used that you took by mouth or, perhaps, by injection? And also, it's important to be open about barriers to obtaining these treatments, whether it [is] cost, transportation to and from the doctor's office, or any other barriers that may have interfered with the effectiveness of any of these treatments.
Another important item to discuss is the amount of psoriasis that you've had. Sometimes doctors think about psoriasis in terms of the amount of body surface that's affected by psoriasis. But, in reality, it's much more complicated than that. For example, a small amount of the body surface, such as the palms and soles or fingers and toes, when affected, can severely interfere with a person's ability to work or to carry on normal relationships with other people. In addition, small areas like the private areas, if affected, can create a lot of anxiety and problems, perhaps, with interpersonal relationships, at a very private level. Some of these topics may be very difficult to discuss with your doctor, especially if you're early on in your relationship with your doctor. However, it's very important to be open and clear about all of these items in order for you to have the best program possible to treat your psoriasis.