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Chapter-11 Psoriasis

BOOK TITLE: Essential of Dermatology, Venereology and Leprosy

Author
1. Chattopadhyay SP
ISBN
9788180610172
DOI
10.5005/jp/books/11611_11
Edition
1/e
Publishing Year
2003
Pages
3
Author Affiliations
1. Armed Forces Medical College Pune, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan; Calcutta Medical and Research Institute, Kolkata, West Bengal, India
Chapter keywords
Psoriasis, Etiology, Histopathology, Clinical features, Complications, Treatments, Local, PUVA, Methotrexate, Calcipotriol.

Abstract

Characterized by presence of erythrosquamous well defined, lesions with a predilection for extensor surface of the body often associated with nail and joint involvement, having a course of relapses and remissions. Aetiology and epidemiology-onset-any age, equal sex incidence, theories of aetiology, inheritance-genetic inheritance or mutation, provocative factors-trauma (koebner’s phenomena), infection (streptococcal sore throat), stress-psoriasis gets aggravated by stress, weather/climate (hot weather improves psoriasis), metabolic (hypercalcaemia, diabetes mellitus), drugs (chloroquine, beta-blockers, corticosteroid with drawl after prolonged). Histopathology: Parakeratosis, elongation of rete ridges, elongation and oedema of dermal papillae. Thinning of suprapapillary. Common types of presentation are as follows-Psoriasis vulgaris, guttata psoriasis, nummular psoriasis Flexural psoriasis, Palmoplantar psoriasis, Pustular psoriasis. Common feature: Well-defined, erythematous, scaly lesions, common sites-scalp, trunk and extensor surface of extremities, koebner’s phenomena-occurrence of isomorphic lesions at sites or trivial trauma, auspitz sing-presence of punctuate bleeding spots on removal of seales by a slide, Woronoff’s sign-presence of a whitish ring round the psoriatic plaques, Nails changes: Thimble pitting, oil drop appearance, Onycholysis, Onychodystrophy. Joints: Arthritis, Seronegative. Complications: Erythroderma, Infections, Arthritis, Eczematization, Amyloidosis. Treatment of psoriasis—no full proves curative treatments. Local treatment-Coal tar bath, local application of urea cream 20 percent, PUVA therapy, and UVA/narrow brand UVB phototherapy with psoralen group drug is useful, in resistant cases Tab methotrexate (2.5 mg) 1-2 tab 2-3 times a week with initial and periodic check up, local application of calcipotriol.

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