Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
psoriasisis a hereditary chronic skin disorder, usually characterized by scaly plaques or papules, and often distributed on areas exposed to frequent minor trauma
Erythroderma is defined as the scaling erythematous dermatitis involving 90% or more of the cutaneous surface.
Also known as exfoliative dermatitis
Idiopathic exfoliative dermatitis – also known as the “red man syndrome”, is characterized by marked palmoplantar keratoderma, dermatopathic lymphadenopathy,increased IgE.
Increased skin perfusion leads to
Temperature dysregulation >
Resulting in skin loss and hypothermia >
High output state >
Cardiac failure
BMR raises to compensate for heat loss
Increased dehydration due to transpiration (similar to burns)
All lead to negative nitrogen balance and characterized by edema, hypoalbuminemia, loss of muscle mass.
psoriasisis a hereditary chronic skin disorder, usually characterized by scaly plaques or papules, and often distributed on areas exposed to frequent minor trauma
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
WHAT ARE THE BEST MEASURES TO REDUCE THE EFFECTS OF HOUSE-DUST MITES ON ASTHMATIC PATIENTS?
DUST MITES PROTECTION IN ASTHMA
are very small, insect-like pests that feed on dead human skin cells and thrive in warm, humid settings. Any swelling (also called inflammation) of the nasal passages caused by dust mites is considered a dust allergy.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation
In the United States, an estimated 1.2 million Americans are living with chronic Hepatitis B and 3.2 are living with chronic Hepatitis C
Many do not know they are infected
Each year an estimated 21,000 persons become infected with Hepatitis A; 35,000 with Hepatitis B, and 17,000 with Hepatitis C
Hepatitis A – fecal/oral, contaminated food, vaccine available
Hepatitis B – blood, semen, vertical (mother-child), vaccine available
Hepatitis C – blood (IV drug use, transfusion, organ donation, unsterile injecting equipment, sexual intercourse)
Hepatitis D – survives only in cells co-infected with hepatitis B
Hepatitis E* – contaminated food or water, fecal/oral
*causes short-term disease and is not a chronic carrier state
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
is an upper respiratory tract bacterial infection associated with a characteristic rash, which is caused by an infection with pyrogenic exotoxin (erythrogenic toxin) -producing GAS in individuals who do not have antitoxin antibodies In the past.
scarlet fever was thought to reflect infection of an individual lacking toxin-specific immunity with a toxin-producing strain of GAS.
Subsequent studies have suggested that development of the scarlet fever rash may reflect a hypersensitivity reaction requiring prior exposure to the toxin.
FA is a very rare, genetic, recessive disease, affecting 1/50,000 people.
Originates from mutations in the “coding” of the mitochondria.
Discovered by Nicholaus Friedreich in the early 1860’s.
Both parents must have the dominant trait for a 25% chance of an offspring possessing the disease.
Not necessarily a disease that kills you, but eventually a wheelchair and regular assistance will be required.
Onset before age 20-25 year.
Propranolol is the most common beta-blocker involved in severe beta-blocker poisoning. It is nonselective and can lead to CNS depression, seizures, and prolongation of the QRS complex.
Beta blocker toxicity is notably distinguished by bradycardia, low respiratory
rate and hypoglycemia
Seizures and other CNS effects can occur with beta blockers that can cross the blood brain barrier (more rarely with the other beta blockers)
Overdoses of beta blockers with a combination of other drugs can have wide
ranging systemic effects
If within a short time after ingestion, give activated charcoal
Treat with glucagon to raise blood glucose levels
Widely used treatment is currently Atropine though it is considered less effective
Treat bronchospasm with beta agonists like Albuterol
Treat Seizures with Benzodiazepines like Valium
If the patient is still unresponsive or the condition is still deteriorating, treat with epinephrine
More than 5.7 million new cases of TB (all forms, both pulmonary and extra-pulmonary) were reported to the World Health Organization (WHO) in 2013; 95% of cases were reported from developing countries
Latest figures from 20151 indicate an estimated 10.4 million people had TB, and 1.8 million people died (1.4 million HIV negative and 400 000 HIV positive).
Of further concern is that 480 000 cases of multidrug-resistant (MDR) TBa and a further 100 000 that were estimated to be rifampicin-resistant (RR) TB have occurred in the same period.
The most common non-cancerous tumours in women .
The most common indication for hysterectomy.
Apparent in up to 25% of women.
More common in a higher body mass index women.
3 times more common in black American women than white women.
Asian women have a lower incidence .
Symptoms appear at age of 30s or 40s .
The incidence increases with age up to the menopause.
Women over the age of 30 are commonly affected by fibroid uterine.
50% of all women are affected by fibroid uterine.
Most common solid pelvic tumors.
Develop in 20~25% of women during reproductive years.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
Is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke.
It can occur
in the carotid
artery of the
neck as well as
other arteries.
When an artery is acutely occluded by thrombus or embolus, the area of the CNS supplied by it will undergo infarction if there is no adequate collateral blood supply.
Surrounding a central necrotic zone, an ‘ischemic penumbra’ remains viable for a time, i.e. it may recover function if blood flow is restored.
CNS ischemia may be accompanied by swelling for two reasons:
● cytotoxic oedema – accumulation of water in damaged glial cells and neurones,
● vasogenic oedema – extracellular fluid accumulation as a result of breakdown of the blood–brain barrier.
In the brain, this swelling may be sufficient to produce clinical deterioration in the days following a major stroke, as a result of a rise in intracranial pressure and compression of adjacent structures.
• The Facial nerve is the 7th of twelve paired cranial nerves.
• It is a mixed nerve with motor and sensory roots.
• It also supplies pre-ganglionic parasympathetic fibres to several
head and neck ganglia
Branches
1. Greater superficial petrosal – arises from the geniculate ganglion.
2. Branches within the facial canal:
• i) nerve to stapedius
• ii) Chorda tympani
3. After exit from stylomastoid foramen:
• i) Posterior auricular
• ii) Nerve to posterior belly of digastric
• iii) Nerve to stylohyoid.
4. On the face - Five major branches:
• i) Temporal
• ii) Zygomatic
• iii) Buccal
• iv) Marginal mandibular
• v) Cervical
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
What is a Pet Scan : Nuclear 3-D imaging test that uses a radioactive substance called a tracer to look for disease in the body.
Shows how organs and tissues are working at a molecular and cellular level. Scan is non-invasive, but does involve exposure to ionizing radiation.
Best known for its role in detecting cancer imaging.
A small amount of a radioactive sugar molecule, 18 fluoro-2-deoxyglucose (FDG), is injected into the bloodstream (can also be inhaled as gas or swallowed in pill form).
A PET Scan is used to detect and generate images that indicate areas of high FDG uptake.
Many cancers require more energy than normal cells, and the FDG tracer accumulates in these cells.
This allows cancers to be seen on the Pet images as hot spots.
Use focusing Shock Waves to breakdown
a stone into small pieces.
Shock waves are acoustic pulses.
Pass through better in water and solid but
not in air.
Introduce in 1980 by Dornier which is a supersonic aircraft company
Somatoform disorders
A disorder in which people have physical illnesses or complaints that cannot be fully explained by actual medical conditions
Dissociative disorders
A personality disorder marked by a disturbance in the integration of identity, memory, or consciousness.
Historically, both somatoform and dissociative disorders used to be categorized as hysterical neurosis
in psychoanalytic theory neurotic disorders result from underlying unconscious conflicts, anxiety that resulted from those conflicts and ego defense mechanisms
"schizophrenia" "split mind" but it refers to a disruption of the usual balance of emotions and thinking.
Schizophrenia is chronic and a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior .
Breast cancer :-
is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
Breast cancer can begin in different parts of the breast:
1- Lobule (the glands that produce milk).
2- Ducts (tubes that carry milk to the nipple).
3- Connective tissue (which consists of fibrous and fatty tissue)( surrounds and holds everything together) .
*Most breast cancers begin in the ducts or lobules.
*Breast cancer can spread outside the breast through blood vessels and lymph vessels.
Zika virus disease is a mosquito-borne viral infection that primarily occurs in tropical and subtropical areas of the world.
It is related to other pathogenic vector borne flaviviruses including dengue, West-Nile and Japanese encephalitis viruses but produces a comparatively mild disease in humans
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: mosquitoes (gut, blood, saliva )
human ( blood, prostate, semen and testes )
Mastering Wealth: A Path to Financial FreedomFatimaMary4
### Understanding Wealth: A Comprehensive Guide
Wealth is a multifaceted concept that extends beyond mere financial assets. It encompasses a range of elements including money, investments, property, and other valuable resources. However, true wealth also includes non-material aspects such as health, relationships, and personal fulfillment. This guide delves into the various dimensions of wealth, exploring how it can be created, sustained, and enjoyed.
#### Defining Wealth
Traditionally, wealth is defined as the abundance of valuable resources or material possessions. It includes financial assets like cash, savings, stocks, bonds, and real estate. However, a broader understanding of wealth considers factors such as personal well-being, emotional health, social connections, and intellectual growth. This holistic view recognizes that true wealth is not solely about accumulating money but also about enhancing one's quality of life.
#### The Importance of Financial Wealth
Financial wealth remains a critical component of overall wealth. It provides security, freedom, and the ability to pursue opportunities. Key elements of financial wealth include:
1. **Savings**: Money set aside for future use. It is crucial for emergencies, large purchases, and financial goals.
2. **Investments**: Assets purchased with the expectation that they will generate income or appreciate over time. Common investments include stocks, bonds, mutual funds, real estate, and businesses.
3. **Income**: Regular earnings from work, investments, or other sources. Consistent income is essential for maintaining and growing wealth.
4. **Debt Management**: Effectively managing debt ensures that it does not erode financial wealth. This includes paying off high-interest debt and using credit wisely.
#### Creating Wealth
Creating wealth involves generating and accumulating financial and non-financial resources. The process can be broken down into several key strategies:
1. Education and Skill Development: Investing in education and skills enhances earning potential. Higher education, professional certifications, and continuous learning can lead to better job opportunities and higher salaries.
2. Entrepreneurship: Starting and running a successful business can be a significant source of wealth. Entrepreneurship requires innovation, risk-taking, and effective management.
3. Investing: Making smart investments is essential for wealth creation. This involves understanding different types of investments, assessing risks, and making informed decisions. Diversifying investments can reduce risk and increase potential returns.
4. Saving and Budgeting: Effective saving and budgeting help accumulate wealth over time. Setting financial goals, creating a budget, and sticking to it are foundational steps in wealth creation.
5. Real Estate: Investing in property can provide rental income and capital appreciation. Real estate is a tangible asset that can hedge against inflation
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
EATING DISORDERS (Psychiatry-7)by dr Shivam sharma.pptxShivam Sharma
For any queries ,contact shvmshrm@outlook.com
---
## Introduction to Eating Disorders
Welcome to this comprehensive presentation on Eating Disorders, a critical and often misunderstood area of mental health. This presentation is designed to provide in-depth knowledge and insights into the various aspects of eating disorders, making it valuable for both postgraduate medical aspirants preparing for the INI-CET and the general public seeking to understand these complex conditions.
### Objectives:
1. **Understanding Eating Disorders**: Gain a clear understanding of what eating disorders are, their types, and their distinguishing characteristics.
2. **Etiology and Risk Factors**: Explore the underlying causes and risk factors that contribute to the development of eating disorders.
3. **Clinical Features and Diagnosis**: Learn about the clinical features, diagnostic criteria, and the importance of early detection.
4. **Management and Treatment**: Review the current approaches to managing and treating eating disorders, including medical, psychological, and nutritional interventions.
5. **Prevention and Awareness**: Discuss strategies for prevention, early intervention, and increasing awareness about eating disorders.
This presentation aims to bridge the gap between academic knowledge and practical understanding, providing you with the tools to recognize, diagnose, and effectively manage eating disorders. Whether you are preparing for a medical exam or seeking to educate yourself or others about these serious conditions, this presentation will equip you with essential information and practical insights.
Let's begin our journey into understanding eating disorders and the significant impact they have on individuals and society.
---
For any queries ,contact shvmshrm@outlook.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. INTRODUCTION
• Psoriasis is a chronic inflammatory
condition that may affect the skin and
joints
Mar 30, 2019 2
3. • Psoriasis affects both sexes equally
• Can occur at any age, although it most
commonly appears for the first time
between the ages of 15 and 25 years
Mar 30, 2019 3
EPIDEMIOLOGY
5. PATHOGENESIS
•Many changes
occur in the skin
•Epidermis –
Acanthosis,
Parakeratosis
•Dermis –
capillaries are
dilated, twisted,
closer to the
surface of the skin
Mar 30, 2019 5
6. • Large number of inflammatory cells are
present in all layers of the skin-
granulocytes are predominant and form
micro-abscessess in the epidermis
• Langerhan cells and lymphocytes are also
increased
• Main abnormality is the increased
epidermal cell turn over
Mar 30, 2019 6
7. Two hypothesis:
1. Hyperproliferation may be due to
immunological response. Cytokines
released by lymphocytes and langerhan
cells may further stimulate the
inflammatory cells which cause
epidermal cell turn over at an increased
rate
Mar 30, 2019 7
8. 2. Epithelial cells themselves produce
cytokines which promote proliferation
of epithelial cells and attract
lymphocytes
Mar 30, 2019 8
9. DIAGNOSIS
• A diagnosis of psoriasis is usually based on the
appearance of the skin
• There are no special blood tests or diagnostic
procedures
• Skin biopsy, 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
Mar 30, 2019 9
12. • It can be on any
size and can affect
any part of the
body
Mar 30, 2019 12
13. • The scales are silvery and easily scraped
off revealing tiny bleed points
• Psoriasis is not typically itchy, but it can
cause itching when severely inflammed
and rapidly spreading to the palms and
soles
Mar 30, 2019 13
14. • Different patterns of psoriasis are:
1. Guttate psoriasis
2. Chronic plaque psoriasis
3. Psoriasis of scalp
4. Psoriasis of nails
5. Psoriasis of palms and soles
6. Flexural psoriasis
7. Erythrodermic and generalized pustular
psoriasis
8. Psoriatic arthropathy
Mar 30, 2019 14
15. GUTTATE
PSORIASIS
Multiple small plaques are
seen all over the body
Mainly seen in children
after streptococcal sore
throat
Self limiting after a few
weeks
Mar 30, 2019 15
17. PSORIASIS OF THE
SCALP
May occur as demarcated
plaques or may involve the
entire scalp extending to the
hairline
Scales are white, thick and
chalky
Hair loss will occur if the
scalp is thickly scaled
Recover if the scales are
cleared and kept under
control
Mar 30, 2019 17
19. PSORIASIS OF THE
PALMS AN SOLES
Sharp demarcation of the
involved areas
Affected areas are inflammed
and scaly and may contain
sterile pustules of large pin
head size. These pustules dry
up and form brown macules
Affected skin becomes
hyperatotic and fissuring
Secondary infection with
itching and pain are common
Mar 30, 2019 19
20. FLEXURAL PSORIASIS
Psoriasis occurs in the axillae,
submammary areas, groin and
genitalia
Demarcation is present, but
the affected areas are glazy
rather than scaly and is bright
red in color
Mar 30, 2019 20
21. ERYTHRODERMIC AND
GENERALIZED
PUSTULAR PSORIASIS
Severe and life threatening condition
Uncommon
Whole skin surface is involved and
highly inflammed and the patient is
sick
Pustules are sterile and coalesce to
form sheets of pus
Mar 30, 2019 21
22. PSORIATIC
ARTHROPATHY
Occurs in 5% of the patients with
psoriasis
Similar to RA, but RF is negative
Different patterns:
1. Distal Arthritis
2. Large Joint Involvement
3. Spodilitis/ Sacroiliitis
Mar 30, 2019 22
23. TREATMENT
Aimed at controlling the current attack and not curing,
and does not influence future progress of the disease
TOPICAL THERAPY
1. Emolients
2. Topical Steroids
3. Dithranol
4. Coal Tar
5. Salicylic Acid
6. Vitamin D Analogues
7. UVB
SYSTEMIC THERAPY
1. PUVA
2. Cytotoxic Drugs
3. Immunosuppressant
Drugs
4. Acitretin
5. Photodynamic Therapy
6. Systemic Steroids
Mar 30, 2019 23
24. TOPICAL THERAPY
1. EMOLIENTS
• Used alone in very mild cases
• Used along with other therapies for moderate to
severe disease
Mar 30, 2019 24
25. 2. TOPICAL STEROIDS
• Most useful for acutely inflammed psoriasis
• Mild steroids are used on face and flexures
• Potent steroids are used on hands and feet; in
combination with Clioquinol or Salicylic acid
• Aq. and alcoholic solutions cause stinging and burning,
thus usually ointments, creams and mousse are prefered
• Use of potent steroids on large areas of psoriasis may
cause rebound flare when discontinued
Mar 30, 2019 25
27. 4. COAL TAR
• Used in combination with emolients, topical steroids,
and salicylic acid
• Used for guttate psoriasis, psoriasis of the scalp, and
localized pustular psoriasis of the palms and soles
• Efficiency of coal tar is enhanced when used with
UVB
Mar 30, 2019 27
28. 5. SALICYLIC ACID
• Useful to remove the scales
• Used in preparation for other treatment
Mar 30, 2019 28
29. 6. VITAMIN D ANALOGUES
• Efficacy of topical vit D analogues is enhanced when
used in combination with topical steroids and UVB
• Calciptriol & Tacalcitol
• Calciptriol is more effective than coal tar and
dithranol. It cannot be used on face.
• Tacalcitol is used for once daily treatment of chronic
plaque psoriasis. It can be used on the face
Mar 30, 2019 29
30. 7. UVB
• Short wavelength ultraviolet light is used in
combination with coal tar or dithranol
• Narrow band UVB is more effective
Mar 30, 2019 30
31. SYSTEMIC THERAPY
1. PUVA
• Used for the treatment of moderate to severe chronic
plaque psoriasis
• PSORALENS: drugs that are activated by UVA (320-
400nm), to interfere with the DNA synthesis and reduce
the epidermal cell turn over
• Eg: 5-methoxy psoralen & 8-methoxy psoralen
• Can be administered orally or it can be applied topically
Mar 30, 2019 31
32. The time of exposure is calculated
based upon the previous light
testing and the time interval is
increased if tolerated by the patient
as the treatment progresses
Treatment is given twice weekly for
6 weeks
Unless the disease is severe,
maintenance dose is avoided to
minimize the long term side effects
Adverse effects: Nausea, pruritis,
dry skin, aging of the skin,
melanoma and non-melanoma skin
cancer
Mar 30, 2019 32
33. 2. CYTOTOXIC DRUGS
• Methotrexate & hydroxycarbamide
• METHOTREXATE
• Most effective in the treatment of psoriatic arthritis
• Test dose- 2.5 mg
• Then 30 mg weekly
• Side effects: nausea, fatigue, GI bleeding
Mar 30, 2019 33
34. • HYDROXYCARBAMIDE
• It should be used continuously as relapse will
occur when the drug is stopped
• Causes bone marrow depression
Mar 30, 2019 34
35. 3. IMMUNOSUPPRESSANT DRUGS
• CICLOSPORIN
• Severe psoriasis
• Dose is 2-5 mg/kg/day
• Relapse may occur when the drug is stopped but
intermittent therapy is preferred to maintenance
therapy
• Avoid sun over exposure, PUVA & UVB therapy
Mar 30, 2019 35
36. 4. ACITRETIN
• Used for severe resistant psoriasis, acute pustular
psoriasis, and palmoplantar psoriasis
• Has teratogenic effect
• Re-PUVA therapy: acitretin + PUVA
• It causes bone maturation abnormality, LFT and
serum lipid levels
• Causes dry skin and hair loss
Mar 30, 2019 36
37. 5. PHOTODYNAMIC THERAPY
• 5-aminolaevullinic acid (ALA) causes local
accumulation of proto porphyrin 9 which is activated
by irradiation with visible light and causes tissue
destruction
• Used for localized plaque psoriasis
• Causes burning sensation at the site of treatment
Mar 30, 2019 37
38. 6. SYSTEMIC STEROIDS
• Not commonly used
• May be used for the management of life threatening
erythroderma
• Systemic steroids or their withdrawal may itself
provoke acute generalised pustular psoriasis
Mar 30, 2019 38