Understanding Psoriasis
Psoriasis is a chronic autoimmune skin disease affecting approximately 1–2% of Singapore's population. It is characterised by well-demarcated, erythematous (red) plaques covered with silvery-white scales, most commonly on the scalp, elbows, knees, and lower back. About 30% of patients develop psoriatic arthritis — joint inflammation that can be debilitating without treatment.
Types of Psoriasis
| Type | Description | Notes |
|---|---|---|
| Plaque (Psoriasis Vulgaris) | 80–90% of cases. Thick silvery plaques on elbows, knees, scalp, trunk. | Most common form |
| Guttate | Small teardrop lesions; often triggered by streptococcal infection. Common in children/young adults. | May resolve spontaneously |
| Pustular | Sterile pustules on palms/soles (PPP) or generalised. Rare but serious. | Requires systemic treatment |
| Erythrodermic | Near-total body involvement; medical emergency (temperature dysregulation, high-output heart failure). | Urgent hospitalisation |
| Inverse | Smooth, shiny plaques in skin folds (groin, axilla, under breasts). Lacks typical scale. | Responds to mild topicals |
| Nail Psoriasis | Pitting, oil drops, onycholysis, subungual hyperkeratosis. Affects 50% of patients. | Often signals psoriatic arthritis risk |
Treatment by Severity
Mild Psoriasis (BSA < 3%)
- Topical corticosteroids (moderate to very potent depending on site)
- Vitamin D analogues (calcipotriol/betamethasone — Dovobet, Enstilar foam)
- Coal tar preparations for scalp
- Topical retinoids (tazarotene)
Moderate-Severe Psoriasis (BSA > 3% or affecting quality of life)
| Treatment | Efficacy Notes | Cost (SGD/month, private) |
|---|---|---|
| Phototherapy (NB-UVB) | 2–3x/week, 20–40 sessions/course | $150–$300/session |
| Methotrexate (oral) | Weekly dose; effective and affordable; liver monitoring required | $50–$150/month |
| Cyclosporine | Fast-acting; short-term courses; kidney/BP monitoring | $100–$250/month |
| Acitretin (oral retinoid) | Good for pustular/erythrodermic; teratogenic — strict contraception required | $100–$200/month |
| TNF inhibitors (adalimumab, etanercept) | PASI 75 in 60–70% of patients | $1,500–$3,500/month |
| IL-17 inhibitors (secukinumab, ixekizumab) | PASI 90 in 70–80% of patients; faster onset | $2,000–$4,000/month |
| IL-23 inhibitors (guselkumab, risankizumab) | PASI 90/100 in 75–90%; inject every 8–12 weeks after loading | $2,000–$4,500/month |
See our researched shortlist: subspecialty focus, credentials and clinic websites, checked against public records.
View the shortlist →No. Psoriasis is a non-contagious chronic autoimmune condition. It cannot be spread by touch, shared surfaces, or air. The red, scaly plaques are caused by an overactive immune response that speeds up skin cell turnover — not by an infection.
There is no permanent cure, but modern biologics (IL-17, IL-23, TNF inhibitors) can achieve near-complete clearance (PASI 90/100) in many patients. Treatment controls the condition very effectively. Flares are triggered by stress, infections, certain medications, alcohol, and smoking.
Dermatology consultations: $80–$200. Topical treatments: $50–$200/month. Phototherapy (NB-UVB): $150–$300/session. Biologics (secukinumab, ixekizumab, guselkumab): $2,000–$5,000/month privately; significantly subsidised at restructured hospitals with appropriate criteria. Methotrexate/cyclosporine: $100–$300/month.
Common triggers include stress, streptococcal throat infections, certain medications (beta-blockers, lithium, antimalarials), alcohol, smoking, skin injury (Koebner phenomenon), and stopping treatment abruptly. Singapore's stress levels and frequent upper respiratory infections are relevant triggers locally.
Outpatient psoriasis treatment is not directly Medisave-claimable. However, if treated at a restructured hospital (SGH, NUH, TTSH), government subsidies apply. Pioneer/Merdeka generation cardholders get additional subsidies. Biologics may be subsidised under the drug assistance programmes (CDAF) at restructured hospitals when criteria are met.