Psoriasis is a chronic immune-driven skin condition affecting roughly 2-3% of adults — and one where modern treatment has genuinely changed what patients can expect. At Fayetteville Dermatology, Dr. James Prezzano treats psoriasis across the full range of severity for patients in Central New York, from a few stubborn plaques to widespread disease. Psoriasis is listed among his clinical areas of expertise, and treatment plans run from simple topicals to the newest biologic therapies.
What Is Psoriasis?
In psoriasis, the immune system signals skin cells to grow much faster than normal. Skin that should renew over a month renews in days, piling up into thickened, scaly, sharply-bordered plaques — most often on the elbows, knees, scalp, and lower back, though nails and skin folds are common too. It's not contagious and not a hygiene issue. Genetics load the gun; triggers like strep infections, stress, certain medications, skin injury, and dry winters (very familiar in Central New York) pull the trigger.
Types We Treat
- Plaque psoriasis — the classic form, 8-9 of every 10 cases
- Guttate — small drop-like spots, often after strep, common in younger patients
- Inverse — smooth red patches in skin folds
- Nail psoriasis — pitting, thickening, lifting nails
- Pustular and other less common forms
More Than Skin Deep
Up to 1 in 3 people with psoriasis develop psoriatic arthritis — joint stiffness, swelling, or morning aching that deserves early attention, because early treatment protects joints. Psoriasis is also associated with cardiovascular and metabolic health risks, which is why Dr. Prezzano treats it as a whole-person condition, not just a skin rash, and coordinates with your primary care physician or rheumatology when needed.
How We Treat Psoriasis at Fayetteville Dermatology
1. Topicals. For limited disease: corticosteroids, vitamin D analogs, and modern combination preparations — chosen by body site, since scalp, face, and skin folds each need different strengths and vehicles.
2. Phototherapy. Narrowband UVB is a well-established option for more widespread disease.
3. Oral systemics. Methotrexate and apremilast remain useful for the right patients.
4. Biologics. For moderate-to-severe psoriasis, biologic therapies targeting IL-17, IL-23, and TNF have transformed outcomes — many patients now achieve clear or almost-clear skin. They require screening and periodic monitoring, and our office handles the prior authorization paperwork with your insurance.
The right choice depends on severity, body sites involved, joint involvement, your other health conditions, and your preferences — there is no one-size-fits-all psoriasis plan.
Psoriasis or Eczema?
The two are often confused, and the treatments differ. Psoriasis plaques tend to be thicker, scalier, and more sharply bordered than eczema. If you've been treating one without results, it's worth a fresh look — confirming the diagnosis is step one of every first visit.
Why See Dr. Prezzano for Psoriasis
Dr. Prezzano is a board-certified dermatologist and Fellow of the American Academy of Dermatology with particular expertise in psoriasis and experience across the modern biologic landscape. Appointments are typically available within a week — which matters when you're flaring.
Frequently Asked Questions
Up to 1 in 3 people with psoriasis develop psoriatic arthritis. Tell us about any joint stiffness, swelling, or morning aching — catching it early protects your joints, and we coordinate with rheumatology when needed.
Yes, to a degree. Weight, alcohol, smoking, and stress all influence severity, and improving them helps treatment work better. But lifestyle changes support treatment — they don't replace it.
Modern biologics are generally well tolerated and have strong long-term safety data. They do require screening before starting and periodic monitoring, and they're not right for everyone — Dr. Prezzano will walk you through the benefits and risks candidly for your situation.
No. Psoriasis is an immune system condition, not an infection. You can't give it to anyone or catch it from anyone.
There's no permanent cure, but psoriasis is highly controllable. With modern treatment — particularly biologics for moderate-to-severe disease — many patients achieve clear or almost-clear skin and stay there. The goal is lasting control, and it's a realistic one.
Schedule Your Mohs Consultation
If you've been diagnosed with a skin cancer — or your primary care provider or another dermatologist has recommended Mohs surgery — we typically have appointments available within the same week.
We accept most major insurance plans including Aetna, BCBS, Cigna, United Healthcare, and Medicare.
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