Episode 37: Psoriasis Explained — Triggers, Treatments, and What Actually Works

Psoriasis is more than just a rash. In this episode, Dr. Dustin Portela and PA Austin Lee break down what psoriasis really is, why it happens, and how treatment has completely changed over the past decade.

They explain the difference between autoimmune and autoinflammatory disease, why psoriasis is driven by inflammatory signaling pathways like TNF alpha, IL-17, and IL-23, and how that inflammation affects more than just the skin. The conversation covers plaque psoriasis, guttate psoriasis, nail psoriasis, inverse psoriasis, erythrodermic psoriasis, and psoriatic arthritis, along with the serious cardiovascular and metabolic risks that can come with uncontrolled disease.

Dustin and Austin also walk through treatment options from old school coal tar and phototherapy to modern topical medications, oral therapies, and the biologic injections that have transformed patient outcomes. They discuss what to expect with lab monitoring, why biologics are far safer than many people assume, and how these medications can be life changing for patients struggling physically and emotionally.

They also touch on lifestyle factors including stress, alcohol, weight, diet, and sunlight, plus the powerful emotional toll psoriasis can take and why treating it often restores far more than just skin.

If you or someone you love has psoriasis, this episode offers clarity, hope, and a roadmap for what modern treatment can look like.

Follow Us:
Dr. Portela
TikTok: @drdustinportela
Instagram: @drdustinportela
YouTube (Reactions): @208SkinDoc
YouTube (Educational): @drdustinportela
Pinterest: @DrDustinPortela

Austin Lee
TikTok: @austinleepac
Instagram: @austinleepac

Product of the Week: Future Clinic

Future Clinic is Dr. Portela's teledermatology platform, currently available in Idaho and New York with more states coming soon. Through a simple monthly subscription starting at $50, patients can receive real medical advice, prescriptions, and follow ups directly from Dr. Portela through the app.

Spots are currently limited, so if you live in Idaho or New York and want direct access to dermatology care, you can sign up through this link.