Psoriasis

PSORIASISDr IMRANA TANVIR

An autoimmune disease that appears on the skin.

It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells.

Psoriasis is not contagious

Five types of psoriasis: Plaque. Guttate. Inverse. Pustular. Erythrodermic. The most common form, plaque psoriasis, is

commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis.

Some patients, have no dermatological symptoms.

In plaque psoriasis, skin rapidly accumulates at these sites, which gives it a silvery-white appearance.

Plaques frequently occur on the skin of the elbows and knees.

It can affect any area, including the scalp, palms of hands and soles of feet, and genitals.

In contrast to eczema, psoriasis is more likely to be found on the outer side of the joint.

A person whose back and arms are affected by psoriasis

Fingernails and toenails are frequently affected (psoriatic nail dystrophy)

Can be seen as an isolated symptom. Psoriasis can also cause inflammation

of the joints, which is known as psoriatic arthritis. Between 10-30% of all people with psoriasis also have psoriatic arthritis.

CAUSES Cause of psoriasis is not fully understood,

but it is believed to have a genetic component and local psoriatic changes can be triggered by an injury to the skin known as the Koebner phenomenon.

Various environmental factors have been suggested as aggravating psoriasis, including stress, withdrawal of systemic corticosteroid,

But few have shown statistical significance.

CLASSIFICATION Nonpustular Psoriasis vulgaris (chronic stationary

psoriasis, plaque-like psoriasis) The most common form of psoriasis. It affects 80 to 90% of people with

psoriasis. Plaque psoriasis typically appears as

raised areas of inflamed skin covered with silvery white scaly skin. These areas are called plaques.

Psoriatic erythroderma (erythrodermic psoriasis) involves the widespread inflammation and exfoliation of the skin over most of the body surface.

It may be accompanied by severe itching, swelling and pain.

It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic treatment.

This form of psoriasis can be fatal, as the extreme inflammation and exfoliation disrupt the body's ability to regulate temperature and for the skin to perform barrier functions

Pustular Pustular psoriasis appears as raised bumps

that are filled with noninfectious pus (pustules).

The skin under and surrounding the pustules is red and tender.

Pustular psoriasis can be localised, commonly to the hands and feet (palmoplantar pustulosis

Generalised with widespread patches occurring on any part of the body

Additional types of psoriasis include Drug-induced psoriasis Inverse psoriasis Seborrheic-like psoriasis Napkin psoriasis

Plaque of psoriasis

Diagnosis Is usually based on the appearance of the skin; There are no special blood tests or diagnostic

procedures. Sometimes, a skin biopsy, or scraping, may be

needed to rule out other disorders and to confirm the diagnosis.

Skin from a biopsy will show clubbed rete pegs if positive for psoriasis.

Another sign of psoriasis is that when the plaques are scraped, one can see pinpoint bleeding from the skin below (Auspitz's sign).

Management

Typically topical agents are used for mild disease.

Phototherapy for moderate disease. Systemic agents for severe disease.

Prognosis Psoriasis is typically a lifelong condition. There is currently no cure. Various treatments can help to control the

symptoms. Many of the most effective agents used to treat severe psoriasis carry an increased risk of significant morbidity including skin cancers, lymphoma and liver disease.

The majority of people's experience of psoriasis is that of minor localized patches, particularly on the elbows and knees, which can be treated with topical medication.

Psoriasis can get worse over time.