{"id":7553,"date":"2017-07-31T00:45:50","date_gmt":"2017-07-30T20:45:50","guid":{"rendered":"http:\/\/aroxjblog.am\/?p=7553"},"modified":"2017-07-31T00:45:50","modified_gmt":"2017-07-30T20:45:50","slug":"psoriasis","status":"publish","type":"post","link":"https:\/\/aroxjblog.am\/en\/psoriasis\/","title":{"rendered":"Psoriasis"},"content":{"rendered":"

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DEFINITION<\/strong>
\nPsoriasis is a chronic skin disorder characterized by excessive proliferation of keratinocytes, resulting in the formation of thickened scaly plaques, itching, and inflammatory changes of the epidermis and dermis. The various forms of psoriasis include guttate, pustular, and arthritis variants.<\/p>\n

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\nPHYSICAL FINDINGS AND CLINICAL PRESENTATION<\/strong>
\n\u25cf The primary psoriatic lesion is an erythematous papule topped by a loosely adherent scale . Scraping the
\nscale results in several bleeding points (Auspitz sign).
\n\u25cf Chronic plaque psoriasis generally manifests with symmetrical, sharply demarcated, erythematous, silver-scaled
\npatches affecting primarily the intergluteal folds, elbows, scalp, fingernails, toenails, and knees . This form
\naccounts for 80% of psoriasis cases.
\n\u25cf Psoriasis can also develop at the site of any physical trauma (sunburn, scratching). This is known as Koebner\u2019s
\nphenomenon.
\n\u25cf Nail involvement is common (pitting of the nail plate), resulting in hyperkeratosis, and onychodystrophy, with
\nonycholysis .
\n\u25cf Pruritus is variable.
\n\u25cf Joint involvement can result in sacroiliitis and spondylitis.
\n\u25cf Guttate psoriasis is generally preceded by streptococcal pharyngitis and manifests with multiple droplike lesions on
\nthe extremities and trunk .<\/p>\n

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CAUSE<\/strong>
\n\u25cf Unknown
\n\u25cf Familial clustering (genetic transmission with a dominant mode with variable penetrants)
\n\u25cf One third of persons affected have a positive family history.
\n\u25cf Within the past decade, several putative loci for genetic susceptibility to psoriasis have been reported. One locus (psoriasis susceptibility 1 [PSORS1] locus) in the major histocompatibility complex (MHC) region on chromosome 6 is considered the most important susceptibility locus.<\/p>\n

LABORATORY TESTS<\/strong>
\n\u25cf Generally not necessary for diagnosis
\n\u25cf Diagnosis is clinical.
\n\u25cf Skin biopsy is rarely necessary.<\/p>\n

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\nTREATMENT<\/strong>
\n\u25cf Sunbathing generally leads to improvement.
\n\u25cf Eliminate triggering factors (e.g., stress, certain medications [lithium, beta blockers, antimalarials]).
\n\u25cf Patients with psoriasis benefi t from a daily bath in warm water followed by the application of a cream or ointment
\nmoisturizer. Regular use of an emollient moisturizer limits evaporation of water from the skin and allows the stratum
\ncorneum to rehydrate itself.
\n\u25cf Therapeutic options vary according to the extent of disease. Approximately 70% to 80% of all patients can be treated adequately with topical therapy.
\n\u25cf Patients with limited disease (less than 20% of the body) can be treated with topical steroids, calcipotriene, tar products, anthralin, and retinoids.
\n\u25cf Therapeutic options for persons with generalized disease (affecting more than 20% of the body) include UVB light
\nexposure three times weekly and oral PUVA. Systemic treatment includes methotrexate and cyclosporine for severe
\npsoriasis. Chronic plaque psoriasis may be treated with alefacept, a recombinant protein that selectively targets
\nT lymphocytes or etanercept, a tumor necrosis factor (TNF) antagonist.<\/p>\n<\/div>\n

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