| a chronic disease that waxes and
wanes. It is never cured, and it is now known
to be associated with multiple comorbidities
including heart disease, diabetes, and the
metabolic syndrome.
signs and symptoms of may subside and then flare-up again
T-lymphocyte–mediated inflammatory disease
resulting from a complex interplay between multiple genetic factors and environmental influences. | Psoriasis |
| Psoriasis two peak
ages of onset | 20 to 30 years of age.
50 to 60 years of age. |
| is CENTRAL to the clinical presentation of
psoriasis | Keratinocyte proliferation |
| PSORIASIS TWO MAJOR ETIOLOGICAL FACTORS: | 1 Genetics
2 Predisposing and precipitating
factors |
| PSORIASIS Predisposing FACTORS | 1 horse-fly bite (Koebner phenomenon)
2 viral or streptococcal infection
3 use of β-adrenergic blockers |
| PSORIASIS Precipitating FACTORS | 1 NSAIDS
2 antimalarials
3 β -adrenergic blockers
4 withdrawal of corticosteroids |
| are responsible for the EPIDERMAL HYPERPLASIA and DERMAL INFLAMMATION that is seen in psoriasis. | Interaction of dermal dendritic cells activated T cells of TH-1, TH-17 lineage with cytokines and growth
factors |
| TYPES OF PSORIASIS | 1 Plaque
2 Flexural or Intertriginous
3 Seborrheic
4 Scalp
5 Acrodermatitis of Hallopeau
6 Palm or soles
7 Erythodermic
8 Guttate
9 Generalized Pustular Psoriasis |
| the most common type of psoriasis; 90% of Psoriasis patients
chronic autoimmune condition; characterized by patches of red, inflamed skin covered with silvery scales.
patches appear on the elbows, knees, scalp, and lower back, but can occur anywhere on the body | Plaque Psoriasis |
| Diagnostic Tests of PSORIASIS | 1.Body surface area (BSA)
2.Psoriasis Area and Severity Index (PASI)
3.Physician’s Global Assessment (static PGA)
4 Quality-of-life measures such as the Dermatology Life Quality Index (DLQI) or the Short Form (SF-36) Health Survey. |
| Nonpharmacologic
Therapy | 1.Stress-reduction strategies
2.Moisturizers
3.Oatmeal baths
4.Skin protection using sunscreens. |
| PSORIASIS Pharmacologic
Therapy | Topical Therapies
1 Corticosteroids (mainstay for the majority)
2 Vitamin D3 Analogues (calcipotriol (calcipotriene), calcitriol (the active metabolite of vitamin D), and tacalcitol)
3 Retinoids (Tazarotene)
4 Anthralin (direct antiproliferative effect)
5 Coal Tar (one of the earliest agents)
6 Salicylic Acid (for patients with scalp
psoriasis)
7 Calcineurin Inhibitors (for atopic
dermatitis) |
| PSORIASIS Pharmacologic
Therapy
1 Phototherapies and Photochemotherapy: | 1.UVB
2.NB-UVB (Narrowband UVB)
3.UVA
4.PUVA (UVA + Psoralens) |
| PSORIASIS Pharmacologic
Therapy
1 Systemic Therapies: | 1.Acitretin
2.Cyclosporine
3.Methotrexate |
