ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel
  • »
  • Health»
  • Diseases, Disorders & Conditions»
  • Skin Diseases & Conditions

Psoriasis: Clinical Presentation, Diagnosis And Treatment

Updated on February 20, 2014

Scalp Psoriasis

Source

A General Overview

This is a chronic inflammatory condition of the skin in which the etiology is largely unknown. It is transmitted as an autosomal dominant trait with irregular penetrace and therefore, it is found more commonly among family members of cases. Around 30% of all cases give a positive family history. All age groups may be affected, although it is rare in infancy and old age. There is no evidence of any infection in these lesions. Both sexes are affected equally.

The lesions appear as erythematous well demarcated patches with loosely adherent silvery scales, when the scales are removed, hyperemia or bleeding points become visible “Auspitz sign". The lesions vary in size and shape. Coalescence of lesions results in the formation of plaques of various geographical patterns. Though all regions of the body can be affected, the common sites of predilection are extensor aspects of the knees and elbows, the scalp, and the sacral region. The disease undergoes spontaneous remission and relapse at variable intervals. Though not a fatal disease, in some it may become very extensive and change over to exfoliative dermatitis or it may show involvement of joints.

Involvement of the nails results in the formation of pin-point sized pits on the surface of the nail plates. The nail plate may get separated from the nail bed by subungual hyperkeratotic material or the nail may become thick and discolored. Irregular furrows may develop on the nail plate. Depending on the morphology or the lesions, various descriptive terms are employed, e.g, “Psoriasis guttata”. When the lesions are of the size of drops and “psoriasis follicularis” when the lesions are found in relation to the pilosebaceous follicles. Psoriasis figurative, psoriasis annulata, psoriasis gyrate and psoriasis discoidae are all terms which describe the morphology of the lesions. Flexoral psoriasis is a definite regional type confined to the flexural aspects.

Several other variant forms of psoriasis exist in addition to the classical forms. These are ‘seborrheic dermatitis like’ psoriasis, lichen planus-like psoriasis, psoriatic erythrodermia and pustular psoriasis. These are less frequent.

Guttate Psoriasis

Source

Diagnosis And Treatment

Diagnosis

Psoriasis has to be differentiated from conditions such as seborrheic dermatitis, secondary and tertiary syphilis, pityriasis rosea, tinea circinata, lichen planus etc. The course of psoriasis is unpredictable. The initial attack may heal completely but it is impossible to predict how long the freedom will last and when the next attack would set in. In cases with incomplete remission, the disease-free interval is likely to be shorter than in cases with complete remission.

Treatment

Local application: An ointment containing salicylic acid 3%, ammoniated mercury 1%, liquor picis carbonis 6% and icthyol 12% in Vaseline base is massaged into the lesion. In many cases, this leads to regression of the lesions within a few weeks. An alternative is an ointment containing crude coal tar (4 to 10%) or dithranol.

Systemic therapy: Psoriasis associated with acute arthritis or which has developed exfoliative dermatitis, responds to systemic corticosteroids. Recently, treatment regimes including oral psoralens followed by ultraviolet light exposure have been advocated (PUVA therapy). In lesions resistant to local therapy, intralesional injections of corticosteroids and occlusive dressing with corticosteroid ointment have been tried with success.

Antimetabolites like methotrexate and other cytotoxic drugs have been employed to inhibit the rapid mitoses of the epidermal cells. Due to their potential toxicity, they should be given only in resistant and extensive cases.

© 2014 Funom Theophilus Makama

Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: "https://hubpages.com/privacy-policy#gdpr"

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized. (Privacy Policy)
    CloudflareThis is used to quickly and efficiently deliver files such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisements has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)