PSORIASIS

- PARTH CHAUHAN (6)

- BHAUMIK PATEL (28)
- GROUP : B1
 Psoriasis is a skin disease that causes a
rash with itchy, scaly patches, most
commonly on the knees, elbows, trunk
and scalp.

 Psoriasis is a common, long-term

(chronic) disease with no cure. It can be
painful, interfere with sleep and make it
hard to concentrate.

 Psoriasis is a long-lasting, noncontagious

autoimmune disease characterized
by raised areas of abnormal skin. These
areas are red, or purple on some people
with darker skin, dry, itchy, and scaly.
Symptoms
The symptoms of psoriasis vary depending on the type you have. Some common
symptoms for plaque psoriasis -- the most common variety of the condition --
include:
• Plaques of red skin, often covered with silver-colored scales. These plaques may
be itchy and painful, and they sometimes crack and bleed. In severe cases, the
plaques will grow and merge, covering large areas.
• Disorders of the fingernails and toenails, including discoloration and pitting of the
nails. The nails may also crumble or detach from the nail bed.
• Plaques of scales or crust on the scalp.
People with psoriasis can also get a type of arthritis called psoriatic arthritis. It
causes pain and swelling in the joints. The National Psoriasis Foundation estimates
that between 10% to 30% of people with psoriasis also have psoriatic arthritis.
Causes
 Psoriasis is thought to be an immune system
problem that causes skin cells to grow faster
than usual. In the most common type of
psoriasis, known as plaque psoriasis, this rapid
turnover of cells results in dry, scaly patches.
 Environmental factors and disease states that
interact with polygenic inheritance patterns
most likely account for the variable expression
of psoriatic disease.
 These include streptococcal pharyngitis
(guttate psoriasis), stressful life events, low
humidity, human immunodeficiency virus (HIV),
trauma, medications, cold, and obesity.
Types
• Pustular psoriasis, which causes red and scaly skin with tiny pustules on the palms of the
hands and soles of the feet.

• Guttate psoriasis, which often starts in childhood or young adulthood, causes small, red
spots, mainly on the torso and limbs. Triggers may be respiratory infections, strep
throat, tonsillitis, stress, injury to the skin, and taking antimalarial and beta-blocker
medications.
 Inverse psoriasis, which makes bright red, shiny lesions that appear in skin folds, such
as the armpits, groin, and under the breasts.

 Erythrodermic psoriasis, which causes fiery redness of the skin and shedding of scales
in sheets. It's triggered by severe sunburn, infections, certain medications, and stopping
some kinds of psoriasis treatment. It needs to be treated immediately because it can
lead to severe illness.
Diagnosis
 The key diagnostic clinical features of psoriasis
are red to pink plaques with silvery white scale on
the elbows, knees, scalp, and lower back and
legs.

 A biopsy is often helpful if the diagnosis is

unclear.

 The microscopic findings of common plaque-type

psoriasis are epidermal hyperplasia,
parakeratosis, thinning of the granular layer,
epidermal infiltration of neutrophils, and
occasional “Munro abscesses” (intraepithelial
collections of neutrophils).
Treatment
 Psoriasis treatments aim to stop skin cells from growing so quickly and to remove
scales. Options include creams and ointments (topical therapy), light therapy
(phototherapy), and oral or injected medications.
 Topical therapy :
 Corticosteroids: Mild corticosteroid ointments (hydrocortisone) are usually
recommended for sensitive areas, such as the face or skin folds, and for treating
widespread patches.
stronger corticosteroid cream or ointment — triamcinolone (Trianex) or clobetasol
(Cormax, Temovate, others) — for smaller, less-sensitive or tougher-to-treat areas.

 Vitamin D analogues: Synthetic forms of vitamin D — such as calcipotriene

(Dovonex, Sorilux) and calcitriol (Vectical) — slow skin cell growth.
 Calcineurin inhibitors: Calcineurin inhibitors — such as tacrolimus (Protopic) and
pimecrolimus (Elidel) — calm the rash and reduce scaly buildup. 

 Salicylic acid: Salicylic acid shampoos and scalp solutions reduce the scaling of
scalp psoriasis. 

 Coal tar: Coal tar reduces scaling, itching and inflammation.

 Anthralin: Anthralin is a tar cream that slows skin cell growth. It can also remove
scales and make skin smoother.
• Light therapy. A doctor shines ultraviolet light on your skin to slow the growth of skin
cells. PUVA is a treatment that combines a medicine called psoralen with a special form of
ultraviolet light.

• Methotrexate. This drug can cause bone marrow and liver disease as well as lung
problems, so it’s only for serious cases. Doctors closely watch patients. You will have to get
lab tests, perhaps a chest X-ray, and possibly a liver biopsy.

• Retinoids. These pills, creams, foams, lotions, and gels are a class of drugs related to
vitamin A. Retinoids can cause serious side effects, including birth defects, so they’re not
recommended for women who are pregnant or planning to have children.

• Cyclosporine. This drug, made to suppress the immune system, may be taken for serious
cases that do not respond to other treatments. It can damage the kidneys and raise blood
pressure, so your doctor will closely watch your health while you take it.