Psoriasis

Psoriasis is a non-contagious chronic inflammatory skin disease, caused by immune system disorder. It is a persistent and recurrent disease with no cure for now. There are two peaks of onset: the first is children aged at 11-12; the second is middle aged people at 50-60. The former is triggered by genetic factors while the latter by environmental factors.

What triggers psoriasis?

    1. Hereditary
    • Close relatives
    • Sweden- 1 parent 28%

                            2 parent 65%

                            None 4%

    • HLA and spontaneous
    • More diseases the further away from equator
    1. Environment

     

    1. Infection
    • Upper Respiratory Infection
    • HIV
    1. Drugs
    • Anti hypertension-ACE inhibitors, β-blockers
    • Arthritis- Interferon, NSAID
    • Anti malarial
    1. Alcohol
    • Anxiety
    • Depression
    • Cigarette related
    1. Smoking
    • palmoplantar pustulosis
    1. Psychology
    • Psychiatric related disorder
    • On Antidepressants
    • Excessive alcohol
    • Yoga diet and meditation helpful
    1. Sunshine
    • helpful in general
    • 5-20% triggered by sun exposure
    1. Injury
    • Trauma sites or old scars
    • Koebner phenomenon

Symptoms

  • Itch, insomnia, tight and hot skin
  • Redness on flexures, genital folds, scalp, ears, nails, mouth and eyes etc
  • Pathology: increased epidermis, inflammatory cells infected and neovascularization
  • Red plagues, with overlying flaky, silvery-white scales; commonly affected areas are skin of the scalp, around the ears, elbows, back and knees
  • Areas with folded skin become wet, inflamed and festered
  • Infected areas develop plagues of thick skin, cracking, inflamed skin and pus-filled blisters
  • Affected nails develop pitting and nail bed separation

Symptoms

  • Itch, insomnia, tight and hot skin
  • Redness on flexures, genital folds, scalp, ears, nails, mouth and eyes etc
  • Pathology: increased epidermis, inflammatory cells infected and neovascularization
  • Red plagues, with overlying flaky, silvery-white scales; commonly affected areas are skin of the scalp, around the ears, elbows, back and knees
  • Areas with folded skin become wet, inflamed and festered
  • Infected areas develop plagues of thick skin, cracking, inflamed skin and pus-filled blisters
  • Affected nails develop pitting and nail bed separation

Complications

  1. Autoimmune diseases
  • Arthritis
  • Inflammatory Bowel Diseases
  • Thyroiditis
  • Type I Diabetes Mellitus
  1. Infection
  • Streptococcus
  • Tonsillitis
  1. Psychology
  • Depression
  • Alcoholic
  • Low self image
  1. Skin Carcinoma
  • Induced by UV
  • Squamous Cell Carcinoma
  • Basal Cell Carcinoma
  • Lymphoma
  1. Endocrine
  • Obesity
  • Hyperlipidemia
  • Hypertension
  • Insulin resistance
  1. Heart
  • Early death associated with arthritis
  • Stroke, Heart attack
  • Ischaemia, Arrhythmia, Vein embolism
  1. Liver
  • lipid
  • alcoholic

Treatment

  1. Emollients in form of ointment & Fatty Urea ointment
  2. Corticosteroid- Tachyphylaxis
  3. Vitamin D3 & Analogues
  4. Tazarotene
  5. Calcineurin Inhibitors
  6. Dithranol
  7. Coal Tar
  8. Salicylic acid