2. DEFINITION
It is one of the most common
skin disease. It is thought that
this chronic disease stems
from a hereditary effect that
causes overproduction of
keratin.
Incidence - It affect
approximately 2% of the
population. It occurs in any
age; most commonly occurs in
people between 15-35 years
of age.
3. It is an inflammatory skin disease in
which the skin cell replicate at an
extremely rapid rate. New cells are
produced 8 times faster then normal
but the rate at which old cells sloughed
off is unchanged, this cause the cell
build up on skin surface, forming thick
patches or plaque of red sores, covered
with flaky, silvery white dead skin cells
(scale).
4. ETIOLOGY
Genetic may aggravate the Condition:
• Stress
• Smoking
• Alcohol
Trauma
Obesity
Hormonal changes
Climate
Autoimmune diseases
Medication
• Lithium salt
• Beta Blockers
5. TYPES OF
PSORIASIS
Plaque psoriasis – also known
as psoriasis vulgaris. It
appear as raised, inflamed
red skin, covered by silvery
patches or scales. Site are: -
elbow, knee, sacrum, scalp,
hands, feet's & lower back.
7. INVERSE
PSORIASIS
It is found in the skin folds
such as inguinal, axilla and
sweating areas. Scaling is
minimal or absent and lesion
appears glossy, smooth and
bright red.
9. ERYTHRODERM
IC PSORIASIS
it is a superficial scaling/
peeling that may appear like
burning. It affect all the body
sites. Causes is sunburn,
allergic reaction and strong
coal product use.
10. NAIL PSORIASIS
It appear as small nail,
yellow brown nail with
chalk like debris build up
under nails.
12. PATHOPHISIOLOGY
Due to E/F Hyperactivity of T-cells
Epidermis infiltration &
keratinocyte proliferation
Deregulated inflammatory
response
Large production of
various cytokines
Superficial blood vessels
dilated and vascular
engorgement
Epidermal hyperplasia &
improper cell maturation
Fails to release adequate
lipid which lead to flaking,
scaling presentation of
psoriasis lesion
Silvery scale of the skin
13. CLINICAL
MANIFESTATIONS
Patches of the skin is dry, swollen and
inflamed covered with silvery flakes.
Raised and thick skin.
Pain, itching and burning.
Yellow discolouration, pitting and
thickening of the nails are noted if they are
affected.
Cracked and bleeding points, if the scale
are scraped away.
Koebner phenomenon – it is develop at the
site of injury such as scratch or sunburn.
15. MANAGEMENT
1. Topical treatment – it slows overactive
epidermis.
I. Topical corticosteroids – they slow the
turnover by suppressing the immune system
which reduce inflammation & relieve itching.
II. Topical steroids
III. Vitamin D analogues – e.g.. – calcipotriene,
it suppress epidermopoiesis (development of
epidermal cells) causing sloughing of growing
epidermal cells.
IV. Coal tar – dry distillation product of organic
matter heated in the absence of oxygen,
combination of creams, ointments and pastes.
16. V. Tazarotene – it reduce mainly scaling &
plaque Thickness, normalize the DNA
activity.
VI. Topical Calcineurin Inhibitors –
tracolimus, they inhibit activation of the
cells which reduce inflammation and
plaque build up.
VII. Emollients – to avoid dryness. It reduce
scaling and limit pain.
2. Phototherapy
I. Sunlight – activated T-cells in skin are
destroy lead to reduce scaling and
inflammation. II. UV broadband
phototherapy – artificial light
17. MANAGEMENT
Monitor vital sign.
• Examine for sign of infection.
• Keep the lesion clean.
• Motivate the patient to improve the nutrition.
• To provide the antibiotics.
Goal – to reduce the pain Intervention
• Provide the emollients after washing the area it will relieve the
soreness.
• To provide the comfort measures.
• To provide the pain medication which relieves pain
