Psoriasis : Description, Management, Natural Treatment and Advice For Patient

Psoriasis : Description, Management, Natural Treatment and Advice For Patient

Description
● A chronic inflammatory skin disease due to hyperproliferation of keratinocytes and inflammatory cell infiltration

Types
● Chronic plaque psoriasis is the most common type
● Other types include guttate (raindrop lesions), seborrhoeic (naso-labial and retro-auricular), flexural (body folds), pustular (palmar-plantar), and erythrodermic (total body redness)

Epidemiology
● Affects about 2% of the population in the UK
Causes
● Complex interaction between genetic, immunological and environmental factors
● Precipitating factors include trauma (which may produce a Koebner phenomenon), infection (e.g. tonsillitis), drugs, stress, and alcohol

Presentation
● Well-demarcated erythematous scaly plaques
● Lesions can sometimes be itchy, burning or painful
● Common on the extensor surfaces of the body and over scalp
● Auspitz sign (scratch and gentle removal of scales cause capillary bleeding)
● 50% have associated nail changes (e.g. pitting, onycholysis)
● 5-8% suffer from associated psoriatic arthropathy – symmetrical polyarthritis, asymmetrical oligomonoarthritis, lone distal interphalangeal disease, psoriatic spondylosis, and arthritis mutilans (flexion deformity of distal interphalangeal joints)

Management
● General measures - avoid known precipitating factors, emollients to reduce scales
● Topical therapies (for localised and mild psoriasis) - vitamin D analogues, topical corticosteroids, coal tar preparations, dithranol, topical retinoids, keratolytics and scalp preparations
● Phototherapy (for extensive disease) - phototherapy i.e. UVB and photochemotherapy i.e. psoralen+UVA
● Oral therapies (for extensive and severe psoriasis, or psoriasis with systemic involvement) - methotrexate, retinoids, ciclosporin, mycophenolate mofetil, fumaric acid esters and biological agents (e.g. infliximab, etanercept, efalizumab)

Complications
● Erythroderma (see page 33), psychological and social effects

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Psoriasis : Description, Management, Natural Treatment and Advice For Patient 2018-12-29T02:02:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni