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Dr 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.

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Psoriasis

  • 2.  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
  • 3. 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.
  • 4.  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.
  • 5. A person whose back and arms are affected by psoriasis
  • 6.  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.
  • 7.
  • 8. 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.
  • 9. 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.
  • 10. 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
  • 11.  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
  • 12.  Additional types of psoriasis include  Drug-induced psoriasis  Inverse psoriasis  Seborrheic-like psoriasis  Napkin psoriasis
  • 14.
  • 15. 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).
  • 16.
  • 17. Management  Typically topical agents are used for mild disease.  Phototherapy for moderate disease.  Systemic agents for severe disease.
  • 18. 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.