Preface

I am not a doctor. I am a software engineer, and I have psoriasis.

When I was first diagnosed, I did what any engineer would do: I went looking for information. I wanted to understand why. Why my immune system was attacking my own skin, what was actually happening at a molecular level, and what the evidence said about treatment options. What I found was scattered across hundreds of journal articles, clinical guidelines, and patient forums, written either in dense medical jargon or in oversimplified summaries that glossed over the science. There was no single resource that explained the disease rigorously but accessibly, the kind of technical reference an engineer would write for another engineer.

So I wrote one.

This book is my attempt to synthesise the current state of psoriasis science into something comprehensive and honest. Every claim is cited. Every mechanism is explained. Where the evidence is strong, I say so. Where it’s weak or preliminary, I say that too. I’ve tried to give you the same quality of information that a dermatologist would have, presented in a way that doesn’t require a medical degree to follow.

Psoriasis can be a lonely disease. It’s visible, chronic, and widely misunderstood. If you’re reading this because you or someone you love has psoriasis, I want you to know: the science is moving fast. There’s no cure yet, but the treatments available today would have been unimaginable twenty years ago, and the research pipeline is extraordinary. There are real reasons for hope.

This book is published for free at psoriasis.fyi — anyone, anywhere can read it. If you find it useful and want to support the project, you can buy a copy from Amazon. But the information itself should never be behind a paywall.

Anthropic’s Claude has been an invaluable assistant in writing this. It’s been like having a research assistant, a proof-reader, a friend to bounce ideas off of, all in one.

Miko Pawlikowski February 2026