This document provides guidance on examining patients presenting with skin diseases. It details the important aspects of history taking including primary and secondary lesions, subjective and objective symptoms, and pertinent questions regarding duration, site, evolution, and associated symptoms. Physical examination involves detailed description of lesions including morphology, distribution, and configuration. Key signs related to macules, papules, plaques, vesicles, pustules, and other eruption types are defined. The document emphasizes close examination of nails, hair, and mucosal surfaces to identify relevant findings.
Gout is caused by hyperuricemia leading to deposition of monosodium urate crystals in the joints. It most commonly affects the big toe joint. Risk factors include age, sex, diet high in purines, certain medications, and metabolic disorders. Symptoms range from asymptomatic hyperuricemia to acute inflammatory arthritis with severe pain, swelling and redness of affected joints. Chronic gout can lead to tophi formation and renal impairment. Treatment involves lifestyle modifications, medications to reduce uric acid levels like allopurinol, and NSAIDs or colchicine for acute flares. Homeopathy offers natural options for treating both acute and chronic gout.
This document presents a case study of a 42-year-old female factory worker presenting with swelling, redness, cracks and scaling on her feet for 2 months. Her symptoms include burning pain and itching. Her medical history and examination are documented. Differential diagnoses considered include atopic dermatitis, contact dermatitis, xerotic eczema and stasis dermatitis. After analyzing her symptoms according to Kent's approach, the totality of symptoms points toward a picture of Sulphur. Sulphur 30 along with Rub. Met. 30 twice daily for 2 weeks was prescribed, with coconut oil for itching. At follow up after 2 weeks, burning and itching showed slight reduction.
Case presentation in Dermatology erythrodermic psoriasisraheef
- Ahmad, a 50-year-old male, presented with generalized redness and scaling of his skin that began 3 days prior. He had a history of plaque psoriasis 5 years earlier.
- On examination, he had widespread erythema and thick scaling affecting over 90% of his skin surface, thick scaling of his scalp, and nail dystrophy.
- He was diagnosed with erythrodermic psoriasis based on his history of psoriasis, presentation of widespread redness and scaling, and physical examination findings. Erythrodermic psoriasis is a potentially life-threatening exacerbation of psoriasis involving over 90% of the skin surface.
Erythrodermic psoriasis case presentationRumana Hameed
- The patient presented with erythrodermic psoriasis, a severe form of psoriasis affecting most of the body surface. Symptoms included redness, scaling, and itching all over the body.
- A skin biopsy confirmed psoriatic erythroderma. The patient was started on methotrexate and folic acid for immunosuppression along with antibiotics, antihistamines, emollients and corticosteroids to treat symptoms.
- The patient was counseled on lifestyle modifications including avoiding smoking and alcohol, taking oatmeal baths, moisturizing skin, and minimizing sun exposure to manage their condition.
This document summarizes psoriasis, including its epidemiology, etiology, pathogenesis, diagnosis, clinical features, and treatment. Psoriasis is a chronic inflammatory skin condition that affects about 2-3% of the population. It is caused by genetic and environmental factors that trigger an immune response resulting in increased skin cell turnover. Diagnosis is usually based on appearance of red, scaly plaques. Treatment includes topical therapies like corticosteroids and vitamin D analogues as well as phototherapy and systemic drugs for more severe cases.
Psoriasis is a common skin condition characterized by red, scaly skin patches that are usually found on the scalp, elbows and knees, and may be associated with joint pain and stiffness. It is caused by an immune system disorder and is influenced by genetic and environmental factors. Treatment options include topical creams and ointments, oral medications, light therapy, and management of flare-ups through control of triggers like stress, smoking, and alcohol use.
Psoriasis is a chronic, inflammatory skin condition characterized by red scaly patches that is genetically determined. It has various clinical types including plaque, guttate, pustular and erythrodermic psoriasis. Treatment involves topical therapies like emollients, dithranol and topical steroids. For moderate to severe cases, phototherapy using PUVA or systemic therapies like methotrexate are used. Management in health posts focuses initially on topical therapies with referral for extensive or pustular psoriasis requiring further treatment.
The document provides an overview of psoriasis including prevalence, genetics, clinical variants, and treatment options. It states that psoriasis affects 2-4.6% of the population and has genetic and immune system factors. The most common form is chronic plaque psoriasis presenting as raised red lesions often located on the elbows and knees. Treatment includes topical corticosteroids, vitamin D analogs, retinoids, phototherapy, and systemic therapies like methotrexate, cyclosporine, and acitretin. All treatments have potential side effects and limitations.
Gout is caused by hyperuricemia leading to deposition of monosodium urate crystals in the joints. It most commonly affects the big toe joint. Risk factors include age, sex, diet high in purines, certain medications, and metabolic disorders. Symptoms range from asymptomatic hyperuricemia to acute inflammatory arthritis with severe pain, swelling and redness of affected joints. Chronic gout can lead to tophi formation and renal impairment. Treatment involves lifestyle modifications, medications to reduce uric acid levels like allopurinol, and NSAIDs or colchicine for acute flares. Homeopathy offers natural options for treating both acute and chronic gout.
This document presents a case study of a 42-year-old female factory worker presenting with swelling, redness, cracks and scaling on her feet for 2 months. Her symptoms include burning pain and itching. Her medical history and examination are documented. Differential diagnoses considered include atopic dermatitis, contact dermatitis, xerotic eczema and stasis dermatitis. After analyzing her symptoms according to Kent's approach, the totality of symptoms points toward a picture of Sulphur. Sulphur 30 along with Rub. Met. 30 twice daily for 2 weeks was prescribed, with coconut oil for itching. At follow up after 2 weeks, burning and itching showed slight reduction.
Case presentation in Dermatology erythrodermic psoriasisraheef
- Ahmad, a 50-year-old male, presented with generalized redness and scaling of his skin that began 3 days prior. He had a history of plaque psoriasis 5 years earlier.
- On examination, he had widespread erythema and thick scaling affecting over 90% of his skin surface, thick scaling of his scalp, and nail dystrophy.
- He was diagnosed with erythrodermic psoriasis based on his history of psoriasis, presentation of widespread redness and scaling, and physical examination findings. Erythrodermic psoriasis is a potentially life-threatening exacerbation of psoriasis involving over 90% of the skin surface.
Erythrodermic psoriasis case presentationRumana Hameed
- The patient presented with erythrodermic psoriasis, a severe form of psoriasis affecting most of the body surface. Symptoms included redness, scaling, and itching all over the body.
- A skin biopsy confirmed psoriatic erythroderma. The patient was started on methotrexate and folic acid for immunosuppression along with antibiotics, antihistamines, emollients and corticosteroids to treat symptoms.
- The patient was counseled on lifestyle modifications including avoiding smoking and alcohol, taking oatmeal baths, moisturizing skin, and minimizing sun exposure to manage their condition.
This document summarizes psoriasis, including its epidemiology, etiology, pathogenesis, diagnosis, clinical features, and treatment. Psoriasis is a chronic inflammatory skin condition that affects about 2-3% of the population. It is caused by genetic and environmental factors that trigger an immune response resulting in increased skin cell turnover. Diagnosis is usually based on appearance of red, scaly plaques. Treatment includes topical therapies like corticosteroids and vitamin D analogues as well as phototherapy and systemic drugs for more severe cases.
Psoriasis is a common skin condition characterized by red, scaly skin patches that are usually found on the scalp, elbows and knees, and may be associated with joint pain and stiffness. It is caused by an immune system disorder and is influenced by genetic and environmental factors. Treatment options include topical creams and ointments, oral medications, light therapy, and management of flare-ups through control of triggers like stress, smoking, and alcohol use.
Psoriasis is a chronic, inflammatory skin condition characterized by red scaly patches that is genetically determined. It has various clinical types including plaque, guttate, pustular and erythrodermic psoriasis. Treatment involves topical therapies like emollients, dithranol and topical steroids. For moderate to severe cases, phototherapy using PUVA or systemic therapies like methotrexate are used. Management in health posts focuses initially on topical therapies with referral for extensive or pustular psoriasis requiring further treatment.
The document provides an overview of psoriasis including prevalence, genetics, clinical variants, and treatment options. It states that psoriasis affects 2-4.6% of the population and has genetic and immune system factors. The most common form is chronic plaque psoriasis presenting as raised red lesions often located on the elbows and knees. Treatment includes topical corticosteroids, vitamin D analogs, retinoids, phototherapy, and systemic therapies like methotrexate, cyclosporine, and acitretin. All treatments have potential side effects and limitations.
Psoriasis presentation answers all your questions related to Psoriasis. Understand the causes, symptoms , commonly affected parts, what are types of psoriasis, how psoriasis is diagnosed, what are complications experienced by psoriasis patient. Why homeopathy treatment for Psoriasis.
Psoriasis is a chronic, autoimmune disease that causes scaly patches on the skin called plaques when immune system signals speed up skin cell growth. It can affect the nails and has different classifications including plaque, pustular, guttate, and forms linked to arthritis. Psoriasis reduces quality of life similarly to other chronic conditions. Genetics and immune system issues contribute to its cause. Diagnosis is usually based on visual inspection, though biopsies can confirm. Management includes topical treatments, phototherapy, systemic drugs, and alternative therapies. Psoriasis has no cure but available treatments can control symptoms.
Diabetes can cause many complications affecting multiple body systems. People with diabetes are at higher risk for periodontal disease which can lead to tooth loss. High blood sugar levels increase the risk of tooth decay and gum disease. Uncontrolled diabetes can also cause complications like damage to small blood vessels (microangiopathy) and large blood vessels (macroangiopathy), nerve damage (neuropathy), kidney disease (nephropathy), eye disease (retinopathy), foot ulcers and infections. Managing blood sugar levels through medication, diet and lifestyle is important for preventing and treating diabetes complications.
Homoeopathic management of psoriasis clinical tipsdrdeeptichawla
Psoriasis is a chronic, immune-mediated inflammatory skin disorder characterized by well-defined raised red scaling lesions called plaques. It affects around 125 million people worldwide and has no known cause, though genetic and immune system factors are involved. The main symptoms are thick scaly plaques on the elbows, knees, scalp and other areas. Homoeopathic treatment focuses on identifying a constitutional remedy based on the individual symptoms. Several remedies are indicated depending on the characteristics of the lesions and associated symptoms. General measures such as sunlight exposure and moisturizing creams can also help manage symptoms.
Psoriasis is a long-lasting autoimmune disease that causes patches of abnormal skin that are typically red, itchy, and scaly. There are five main types of psoriasis that vary in appearance and location on the body. Psoriasis is caused by a combination of genetic and environmental factors that trigger an immune response and cause skin cells to grow rapidly. Treatment options range from topical therapies for mild cases to phototherapy and systemic drugs for more severe psoriasis.
Toxic epidermal necrolysis (TEN) is a rare, potentially fatal adverse drug reaction characterized by extensive skin detachment and mucous membrane involvement. It is caused by apoptosis of keratinocytes triggered by certain drugs in genetically susceptible individuals. TEN is diagnosed clinically based on >30% detachment of the epidermis. Management involves stopping the causative drug, supportive care, and investigational therapies to prevent apoptosis. Complications include infection, organ failure and death in around 30% of cases. Prognosis can be estimated using the SCORTEN severity-of-illness score.
Psoriasis is a chronic skin condition characterized by excessive skin cell growth. It has both genetic and environmental triggers. The most common form, plaque psoriasis, presents as raised, red patches covered with silvery scales on the elbows, knees, scalp and other areas. Treatment depends on the severity but includes topical creams and ointments, phototherapy, oral medications and newer biologic therapies that target specific proteins involved in inflammation. While there is no cure for psoriasis, current treatments can effectively control symptoms and clear the skin lesions.
This document defines common skin conditions and provides guidance on evaluating dermatology presentations in the emergency department. It reviews terminology, discusses common non-serious conditions like urticaria and eczema, and outlines serious but rare disorders involving blistering or skin loss such as erythema multiforme major, pemphigus, pemphigoid, and toxic epidermal necrolysis. Red flags are identified that warrant discussion with a senior colleague or dermatologist.
A 4-year-old Egyptian boy presented with sudden onset left cheek swelling for 1 day. Examination revealed a diffuse 5x6cm swelling on the left cheek that was painful and itchy. Laboratory tests were normal. The diagnosis was an insect sting based on the history and examination findings. The swelling was treated with cold compression, antihistamines, and analgesics.
The patient presented with intense pruritus and hives for 3 months. Investigations revealed enlarged lymph nodes. A lymph node biopsy showed Hodgkin's lymphoma stage IIA. Pruritus is a common symptom of Hodgkin's lymphoma. While hives are uncommon, urticaria can occur due to allergic or infectious causes. The patient's pruritus and previous episode of Kikuchi's disease suggested an underlying systemic illness which was diagnosed as Hodgkin's lymphoma based on biopsy findings. Pruritus can indicate internal diseases like liver, kidney, hematological or endocrine disorders and in rare cases, malignancy.
This document discusses psoriasis, including its epidemiology, pathogenesis, clinical features, diagnosis, and treatment. Psoriasis is a chronic inflammatory skin condition that causes red, scaly plaques and affects the skin and joints. It occurs equally in both sexes and most commonly appears for the first time between ages 15-25. The pathogenesis involves hyperproliferation of skin cells and an immune response characterized by inflammatory cells in the skin. Diagnosis is usually based on appearance, and biopsy may be used to confirm. Treatment includes topical therapies like steroids, vitamin D analogues, and UVB, as well as systemic therapies like PUVA, methotrexate, ciclosporin,
Psoriasis is a chronic inflammatory skin disease characterized by thick red patches covered with silvery scales. It occurs when skin cells replicate too quickly, causing a buildup on the skin's surface. The causes are genetic and can be aggravated by stress, alcohol, and smoking. There are several types including plaque, guttate, pustular, and nail psoriasis. Treatment involves topical creams and drugs to reduce inflammation and rapid cell turnover, as well as phototherapy. Nursing care focuses on skin protection, education, and promoting self-acceptance of the condition.
Psoriasis and Management in Primary CareKochi Chia
1. Psoriasis is a chronic, immune-mediated skin disorder characterized by patches of abnormal skin that are typically red, itchy, and scaly. It occurs worldwide and has various clinical subtypes defined by the appearance of the rashes.
2. The pathogenesis of psoriasis involves an interplay between immune system dysfunction, epidermal keratinocyte hyperproliferation, and vascular changes. Genetic and environmental factors contribute to its development.
3. Psoriasis is associated with increased risks of comorbidities like psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Treatment involves topical agents for mild cases and progresses to phototherapy, systemic drugs, and bi
Psoriasi dalla diagnosi agli approcci cliniciMaria De Chiaro
Psoriasis is a chronic, inflammatory skin condition characterized by red patches covered with silvery scales. It has various clinical presentations including plaque, guttate, flexural, pustular, and nail psoriasis. The document discusses the epidemiology, pathogenesis, clinical features, differential diagnosis, and management of psoriasis. Key points include that psoriasis has a strong genetic component, can be triggered by infections or stress, and presents as well-defined erythematous scaly plaques typically affecting the scalp, elbows, knees and back.
Stem Cell Therapy in Psoriasis. DR. SHARDA JAIN Dr. Jyoti Aggarwal Dr. Rash...Lifecare Centre
This document discusses psoriasis and stem cell therapy for treating it. It provides an overview of psoriasis, describing it as an inflammatory skin disease characterized by red patches covered with silvery scales. It outlines different types of psoriasis and lists common triggers. The document also discusses the negative psychological and physical impacts of psoriasis as well as current treatment options like topical agents and methotrexate. It presents stem cell therapy as a promising new treatment for severe psoriasis resistant to conventional therapies, noting it may work through paracrine effects and immune modulation. Finally, it shares stories of patients who found relief from psoriasis and related conditions through stem cell therapy.
This document discusses two major complications of diabetes: hypertension and diabetic neuropathy. It defines hypertension as blood pressure above 140/90 and explains that diabetes increases the risk of hypertension because it restricts blood flow and forces the heart to work harder. Nearly half of all diabetics experience some form of diabetic neuropathy, which is nerve damage caused by restricted blood flow. Peripheral neuropathy and autonomic neuropathy are the most common types and can cause numbness, pain, and digestive issues. Managing both complications involves keeping blood sugar in target ranges, monitoring blood pressure, and being screened regularly by a doctor.
This document provides an overview of psoriasis, including:
- It is a chronic, immune-mediated skin disorder that mainly affects the skin and joints.
- The prevalence is estimated to be over 125 million people worldwide, with various clinical manifestations and comorbidities like psoriatic arthritis.
- The diagnosis is typically made clinically based on characteristics of the skin lesions and nails, and differential diagnoses need to be considered.
- Both genetic and environmental factors contribute to its complex etiology, involving the immune system and cross-talk between skin and immune cells.
This document discusses Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and erythema multiforme (EM). It defines SJS and TEN as rare, life-threatening diseases caused by extensive keratinocyte cell death. SJS is distinguished from TEN based on the extent of epidermal detachment. The document outlines risk factors, pathogenesis, clinical features, investigations, differential diagnosis, management including wound care, and complications of SJS, TEN and EM. Management involves discontinuing causative drugs, fluid and electrolyte replacement, nutritional support, wound dressing, and in some cases corticosteroids, cyclosporine or IV immunoglobulins. Progn
This document defines psoriasis as a chronic, immune-mediated inflammatory skin disease characterized by well-circumscribed erythematous scaly plaques. It disrupts the normal cycle of skin cell proliferation and differentiation, causing keratinocytes to replicate rapidly within days rather than weeks. Psoriasis has no cure, but can be managed with topical therapies like vitamin D analogs, phototherapy, or systemic drugs when widespread. Calcipotriol is a first-line topical therapy that exerts immunomodulatory and anti-proliferative effects on keratinocytes and T cells to reduce inflammation and hyperplasia.
This document discusses emergency dermatology situations that require prompt management. It focuses on three main areas: severe drug reactions like toxic epidermal necrolysis which requires immediate drug cessation; serious infections like meningococcal disease signaled by palpable purpura that needs rapid antibiotics; and erythroderma involving over 90% of body surface that can cause systemic issues like fluid/electrolyte imbalance. Early recognition and treatment of these conditions is important to minimize patient harm.
The integumentary system consists of three main layers - the epidermis, dermis and hypodermis. The skin is the largest organ and acts as a protective barrier. It has several important functions including protection, temperature regulation, sensation, vitamin D synthesis and immune response. Common skin conditions are assessed by examining primary lesions such as macules, papules and vesicles, as well as secondary lesions. Diagnostic tests may include microscopy, culture, biopsy and patch testing to identify causes and guide treatment. Skin grafts and flaps are surgical procedures to repair defects and promote wound healing.
This document discusses the clinical presentation and diagnosis of various skin lesions. It describes key characteristics of macules, papules, plaques, nodules, vesicles, pustules, wheals, erosions, cysts, scaling, crusting, and other lesions. Highlighted are examples like iris-type lesions seen in conditions like erythema multiforme and granuloma annulare. The document emphasizes the importance of assessing lesion type, distribution, evolution over time, and correlating physical exam findings with patient history for accurate diagnosis of skin conditions.
Psoriasis presentation answers all your questions related to Psoriasis. Understand the causes, symptoms , commonly affected parts, what are types of psoriasis, how psoriasis is diagnosed, what are complications experienced by psoriasis patient. Why homeopathy treatment for Psoriasis.
Psoriasis is a chronic, autoimmune disease that causes scaly patches on the skin called plaques when immune system signals speed up skin cell growth. It can affect the nails and has different classifications including plaque, pustular, guttate, and forms linked to arthritis. Psoriasis reduces quality of life similarly to other chronic conditions. Genetics and immune system issues contribute to its cause. Diagnosis is usually based on visual inspection, though biopsies can confirm. Management includes topical treatments, phototherapy, systemic drugs, and alternative therapies. Psoriasis has no cure but available treatments can control symptoms.
Diabetes can cause many complications affecting multiple body systems. People with diabetes are at higher risk for periodontal disease which can lead to tooth loss. High blood sugar levels increase the risk of tooth decay and gum disease. Uncontrolled diabetes can also cause complications like damage to small blood vessels (microangiopathy) and large blood vessels (macroangiopathy), nerve damage (neuropathy), kidney disease (nephropathy), eye disease (retinopathy), foot ulcers and infections. Managing blood sugar levels through medication, diet and lifestyle is important for preventing and treating diabetes complications.
Homoeopathic management of psoriasis clinical tipsdrdeeptichawla
Psoriasis is a chronic, immune-mediated inflammatory skin disorder characterized by well-defined raised red scaling lesions called plaques. It affects around 125 million people worldwide and has no known cause, though genetic and immune system factors are involved. The main symptoms are thick scaly plaques on the elbows, knees, scalp and other areas. Homoeopathic treatment focuses on identifying a constitutional remedy based on the individual symptoms. Several remedies are indicated depending on the characteristics of the lesions and associated symptoms. General measures such as sunlight exposure and moisturizing creams can also help manage symptoms.
Psoriasis is a long-lasting autoimmune disease that causes patches of abnormal skin that are typically red, itchy, and scaly. There are five main types of psoriasis that vary in appearance and location on the body. Psoriasis is caused by a combination of genetic and environmental factors that trigger an immune response and cause skin cells to grow rapidly. Treatment options range from topical therapies for mild cases to phototherapy and systemic drugs for more severe psoriasis.
Toxic epidermal necrolysis (TEN) is a rare, potentially fatal adverse drug reaction characterized by extensive skin detachment and mucous membrane involvement. It is caused by apoptosis of keratinocytes triggered by certain drugs in genetically susceptible individuals. TEN is diagnosed clinically based on >30% detachment of the epidermis. Management involves stopping the causative drug, supportive care, and investigational therapies to prevent apoptosis. Complications include infection, organ failure and death in around 30% of cases. Prognosis can be estimated using the SCORTEN severity-of-illness score.
Psoriasis is a chronic skin condition characterized by excessive skin cell growth. It has both genetic and environmental triggers. The most common form, plaque psoriasis, presents as raised, red patches covered with silvery scales on the elbows, knees, scalp and other areas. Treatment depends on the severity but includes topical creams and ointments, phototherapy, oral medications and newer biologic therapies that target specific proteins involved in inflammation. While there is no cure for psoriasis, current treatments can effectively control symptoms and clear the skin lesions.
This document defines common skin conditions and provides guidance on evaluating dermatology presentations in the emergency department. It reviews terminology, discusses common non-serious conditions like urticaria and eczema, and outlines serious but rare disorders involving blistering or skin loss such as erythema multiforme major, pemphigus, pemphigoid, and toxic epidermal necrolysis. Red flags are identified that warrant discussion with a senior colleague or dermatologist.
A 4-year-old Egyptian boy presented with sudden onset left cheek swelling for 1 day. Examination revealed a diffuse 5x6cm swelling on the left cheek that was painful and itchy. Laboratory tests were normal. The diagnosis was an insect sting based on the history and examination findings. The swelling was treated with cold compression, antihistamines, and analgesics.
The patient presented with intense pruritus and hives for 3 months. Investigations revealed enlarged lymph nodes. A lymph node biopsy showed Hodgkin's lymphoma stage IIA. Pruritus is a common symptom of Hodgkin's lymphoma. While hives are uncommon, urticaria can occur due to allergic or infectious causes. The patient's pruritus and previous episode of Kikuchi's disease suggested an underlying systemic illness which was diagnosed as Hodgkin's lymphoma based on biopsy findings. Pruritus can indicate internal diseases like liver, kidney, hematological or endocrine disorders and in rare cases, malignancy.
This document discusses psoriasis, including its epidemiology, pathogenesis, clinical features, diagnosis, and treatment. Psoriasis is a chronic inflammatory skin condition that causes red, scaly plaques and affects the skin and joints. It occurs equally in both sexes and most commonly appears for the first time between ages 15-25. The pathogenesis involves hyperproliferation of skin cells and an immune response characterized by inflammatory cells in the skin. Diagnosis is usually based on appearance, and biopsy may be used to confirm. Treatment includes topical therapies like steroids, vitamin D analogues, and UVB, as well as systemic therapies like PUVA, methotrexate, ciclosporin,
Psoriasis is a chronic inflammatory skin disease characterized by thick red patches covered with silvery scales. It occurs when skin cells replicate too quickly, causing a buildup on the skin's surface. The causes are genetic and can be aggravated by stress, alcohol, and smoking. There are several types including plaque, guttate, pustular, and nail psoriasis. Treatment involves topical creams and drugs to reduce inflammation and rapid cell turnover, as well as phototherapy. Nursing care focuses on skin protection, education, and promoting self-acceptance of the condition.
Psoriasis and Management in Primary CareKochi Chia
1. Psoriasis is a chronic, immune-mediated skin disorder characterized by patches of abnormal skin that are typically red, itchy, and scaly. It occurs worldwide and has various clinical subtypes defined by the appearance of the rashes.
2. The pathogenesis of psoriasis involves an interplay between immune system dysfunction, epidermal keratinocyte hyperproliferation, and vascular changes. Genetic and environmental factors contribute to its development.
3. Psoriasis is associated with increased risks of comorbidities like psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Treatment involves topical agents for mild cases and progresses to phototherapy, systemic drugs, and bi
Psoriasi dalla diagnosi agli approcci cliniciMaria De Chiaro
Psoriasis is a chronic, inflammatory skin condition characterized by red patches covered with silvery scales. It has various clinical presentations including plaque, guttate, flexural, pustular, and nail psoriasis. The document discusses the epidemiology, pathogenesis, clinical features, differential diagnosis, and management of psoriasis. Key points include that psoriasis has a strong genetic component, can be triggered by infections or stress, and presents as well-defined erythematous scaly plaques typically affecting the scalp, elbows, knees and back.
Stem Cell Therapy in Psoriasis. DR. SHARDA JAIN Dr. Jyoti Aggarwal Dr. Rash...Lifecare Centre
This document discusses psoriasis and stem cell therapy for treating it. It provides an overview of psoriasis, describing it as an inflammatory skin disease characterized by red patches covered with silvery scales. It outlines different types of psoriasis and lists common triggers. The document also discusses the negative psychological and physical impacts of psoriasis as well as current treatment options like topical agents and methotrexate. It presents stem cell therapy as a promising new treatment for severe psoriasis resistant to conventional therapies, noting it may work through paracrine effects and immune modulation. Finally, it shares stories of patients who found relief from psoriasis and related conditions through stem cell therapy.
This document discusses two major complications of diabetes: hypertension and diabetic neuropathy. It defines hypertension as blood pressure above 140/90 and explains that diabetes increases the risk of hypertension because it restricts blood flow and forces the heart to work harder. Nearly half of all diabetics experience some form of diabetic neuropathy, which is nerve damage caused by restricted blood flow. Peripheral neuropathy and autonomic neuropathy are the most common types and can cause numbness, pain, and digestive issues. Managing both complications involves keeping blood sugar in target ranges, monitoring blood pressure, and being screened regularly by a doctor.
This document provides an overview of psoriasis, including:
- It is a chronic, immune-mediated skin disorder that mainly affects the skin and joints.
- The prevalence is estimated to be over 125 million people worldwide, with various clinical manifestations and comorbidities like psoriatic arthritis.
- The diagnosis is typically made clinically based on characteristics of the skin lesions and nails, and differential diagnoses need to be considered.
- Both genetic and environmental factors contribute to its complex etiology, involving the immune system and cross-talk between skin and immune cells.
This document discusses Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and erythema multiforme (EM). It defines SJS and TEN as rare, life-threatening diseases caused by extensive keratinocyte cell death. SJS is distinguished from TEN based on the extent of epidermal detachment. The document outlines risk factors, pathogenesis, clinical features, investigations, differential diagnosis, management including wound care, and complications of SJS, TEN and EM. Management involves discontinuing causative drugs, fluid and electrolyte replacement, nutritional support, wound dressing, and in some cases corticosteroids, cyclosporine or IV immunoglobulins. Progn
This document defines psoriasis as a chronic, immune-mediated inflammatory skin disease characterized by well-circumscribed erythematous scaly plaques. It disrupts the normal cycle of skin cell proliferation and differentiation, causing keratinocytes to replicate rapidly within days rather than weeks. Psoriasis has no cure, but can be managed with topical therapies like vitamin D analogs, phototherapy, or systemic drugs when widespread. Calcipotriol is a first-line topical therapy that exerts immunomodulatory and anti-proliferative effects on keratinocytes and T cells to reduce inflammation and hyperplasia.
This document discusses emergency dermatology situations that require prompt management. It focuses on three main areas: severe drug reactions like toxic epidermal necrolysis which requires immediate drug cessation; serious infections like meningococcal disease signaled by palpable purpura that needs rapid antibiotics; and erythroderma involving over 90% of body surface that can cause systemic issues like fluid/electrolyte imbalance. Early recognition and treatment of these conditions is important to minimize patient harm.
The integumentary system consists of three main layers - the epidermis, dermis and hypodermis. The skin is the largest organ and acts as a protective barrier. It has several important functions including protection, temperature regulation, sensation, vitamin D synthesis and immune response. Common skin conditions are assessed by examining primary lesions such as macules, papules and vesicles, as well as secondary lesions. Diagnostic tests may include microscopy, culture, biopsy and patch testing to identify causes and guide treatment. Skin grafts and flaps are surgical procedures to repair defects and promote wound healing.
This document discusses the clinical presentation and diagnosis of various skin lesions. It describes key characteristics of macules, papules, plaques, nodules, vesicles, pustules, wheals, erosions, cysts, scaling, crusting, and other lesions. Highlighted are examples like iris-type lesions seen in conditions like erythema multiforme and granuloma annulare. The document emphasizes the importance of assessing lesion type, distribution, evolution over time, and correlating physical exam findings with patient history for accurate diagnosis of skin conditions.
This document provides guidance on diagnosing skin diseases. It outlines the key steps which include taking a thorough history, examining the patient for symptoms and signs of skin abnormalities, and performing relevant investigations. The history should explore symptoms of itching, pain, tingling and include questions on duration, triggers, and associated symptoms. The examination classifies primary skin lesions based on features like size, morphology, arrangement and distribution. Secondary lesions resulting from trauma or evolution are also described. Common diagnostic tools like magnifying lenses, glass slides for diascopy, and wood lamps are listed.
Primary skin lesions include macules, papules, plaques, nodules, tumors, and wheals. Secondary lesions develop from primary lesions and include scales, crusts, excoriations, fissures, erosions, ulcers, and scars. Special lesions occur under certain conditions and include erythema, telangiectasia, purpura, petechiae, ecchymoses, vibices, and hematomas. The document provides detailed definitions and descriptions of these various skin lesions.
This document provides information about various skin diseases and disorders. It begins by defining different primary skin lesions such as macules, papules, nodules, etc. It then classifies skin disorders into five main categories: acute inflammatory dermatoses, chronic inflammatory dermatoses, infectious dermatoses, blistering disorders, and skin tumors. Examples of specific conditions are provided for each category. More detail is given about conditions like eczema, urticaria, pemphigus, and psoriasis - outlining their pathogenesis, clinical features, types, treatment and more. In summary, the document covers a wide range of skin diseases and lesions at both a high level and with more in-depth explanations of
This document provides an overview of the integumentary system, including the structure and function of the skin and its layers. It discusses the epidermis and dermis in depth, describing the cells that make up each layer. The document also covers skin appendages like hair follicles, sebaceous glands, and nails. Additionally, it summarizes the functions of the skin and describes common skin conditions like psoriasis, outlining its causes, types, symptoms, and diagnostic evaluation.
This document defines and describes various primary and secondary skin lesions seen in veterinary dermatology. It defines primary lesions as those directly associated with the underlying disease process, such as macules, papules, plaques, nodules, tumors, pustules, vesicles, wheals, and cysts. Secondary lesions result from trauma, time, or degree of skin insult and include comedones, crusts, erythema, erosions, ulcers, sinuses/fistulas, self-trauma, scars, fissures, lichenification, hyperpigmentation, and hypopigmentation. Each lesion is concisely defined and an example image provided for illustration.
This document describes how to describe various skin lesions by their features and type. It discusses primary lesions like macules, papules, plaques, nodules, vesicles, bullae and pustules. It also covers secondary lesions developed from skin diseases like scales, crusts, erosions and fissures. Finally, it provides examples of specific lesions and how they can be classified by their appearance, shape, arrangement and distribution on the body.
This document describes how to describe various skin lesions by their features and type. It discusses primary lesions like macules, papules, plaques, nodules, vesicles, bullae and pustules. It also covers secondary lesions developed from skin diseases like scales, crusts, erosions and fissures. Finally, it provides examples of specific lesions and how they can be classified by their appearance, shape, arrangement and distribution on the body.
Assessment and diagnostic evaluation of integumentary systemyashwant ramawat
The document discusses the anatomy, physiology, and assessment of the skin and common dermatological disorders. It describes the three layers of the skin, glands and appendages. Assessment involves health history questions, physical exam of lesions/rashes, nail changes, hair characteristics, and diagnostic tests like biopsy. Common disorders are often found in specific anatomical areas like the face, scalp, or genital regions. The nurse examines skin thoroughly and asks targeted questions to identify dermatological problems.
The document provides information about examining the skin. It discusses the structure of skin including its three layers - epidermis, dermis and subcutaneous tissue. It describes epidermal appendages like hair, nails and glands. The functions of skin and appendages are explained. Guidelines are given for taking a skin history and conducting a physical examination including inspection, palpation and documentation of lesions. Common primary and secondary skin lesions are defined and examples are shown.
Primary skin lesions include macules, papules, plaques, nodules, wheals, angioedema, vesicles, bullae, pustules, cysts, and abscesses. Secondary lesions result from primary lesions and include crusts, excoriations, erosions, ulcers, and scars. Special lesions are diagnostic of particular diseases such as burrows, comedones, milia, and telangiectasia.
The skin is composed of three layers: the epidermis, dermis, and hypodermis. The epidermis contains keratinocytes and dendritic cells. It has multiple layers including the basal, spinous, granular, clear, and horny layers. The dermis contains fibrous and cellular connective tissue with nerve and vascular networks. The hypodermis contains adipose tissue and larger blood vessels and nerves. The skin has several functions including serving as a barrier, regulating temperature, sensation, vitamin D synthesis, and as a blood reservoir. Primary skin lesions include macules, papules, vesicles, pustules, nodules, and plaques. Secondary lesions develop from primary lesions and include scales
This document discusses the integumentary system and common dermatologic terms and skin lesions. It provides descriptions of primary and secondary skin lesions, how to assess the skin, common disorders of the skin including inflammatory, bacterial, fungal and viral infections. Specific conditions discussed in detail include eczema, acne, psoriasis and their signs and symptoms.
This document provides classifications and definitions for primary and secondary skin lesions. Primary lesions include macules, patches, papules, plaques, nodules, vesicles, bullae, pustules, and wheals. Secondary lesions result from primary lesions and include scales, crusts, erosions, fissures, scars, atrophy, keloids, and lichenification. The document also describes the levels of fluid collection in blistering disorders and provides examples of various skin lesion shapes and arrangements.
This document provides information on various skin conditions and disorders. It describes conditions like acne, athlete's foot, burns of varying degrees, dermatitis, eczema, herpes, impetigo, psoriasis, ringworm, scabies, and several types of skin cancer. It also defines different types of skin lesions like macules, vesicles, pustules, and papules. Treatments are mentioned for many of the conditions.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
1. Dermatology
Approach to the patient with skin
disease
By Dr kirtida desai,MD(Homeo)
Professor, HOD-practice of medicine
PG, Phd guide
2. History taking
Try to get information regarding primary lesion and
secondary lesion of the skin.
Primary- original picture of skin disease eg tinea,
where ring shaped eruptions are present
Secondary- same eruption gets altered over period of
time due to constant itching, scratching, scab
formation and some times with secondary infection.
We may find lichenification due to scratching.
3. Presenting Complaints
Patients present to the dermatologist with a variety of
complaints,
which can be grouped as:
Subjective symptoms:
Which cannot be seen by physician
it include symptoms like itching, pain, and paresthesia etc
Objective symptoms:
Which can be seen by a doctor
it include symptoms like rash, ulcers, hair fall (or
growth),changes in nails, etc.
4. ODP
For each symptom, the following questions should be
asked:
Duration: Is the problem acute or chronic? If chronic,
about relapses and remissions.
Site of first involvement: And spread.
Evolution: Of lesions.
Duration
Diurnal variation: In most dermatoses, itching is
generally more severe at night because the patient’s
mind is not diverted.
But in sun-induced dermatosis, the itching is logically
worse during day.
5. Symptoms asociated with eruption, how it’s relieved
Ailments from-Recent medication, new food eg fish, eggs
etc ,(protein present in these food may cause
hypersensitivity reaction), colouring or preservatives
added in food etc may cause allergy.
Contact with plants must be inquired
Associated systemic symptoms, eg fever, malaise,
arthralgia etc
Ongoing illness like sarcoidosis, restrictive lung disese,
bronchial asthama etc
h/o allergy
h/o photosensitivity
6. Subjective symptoms- itching ,
pain, paraesthesia inquire…
Diurnal variation-
scabies – agg night
Photosensitivity only during day
Seasonal variation-
Summer- miliary euption, mosquito bite, fungal
infection etc
Winter- psoriasis, ichthiosis, raynaud’s disease,
Chilblain etc
Agg of pain in winter in systemic sclerosis
7. Precipitated by exercise-collinergic urticarea,
intermittant claudication(pain)
Precipitated by cold- cold urticarea, raynaud’s
phenomena(pain and chilblain)
Associated symptoms- rash with fever in systemic
disease like measles,
Wheel- with fever and itching in allergic conditions
hypopigmented patches eg parasthesia in leprosy
Pain with rash and eruption- herpes zoster
8. wheals, cyanosis, gangrene, hypopigmented
lesions, neuritis and sensory impairment.
Look for nail changes, hair loss, and involvement of
palms, soles, scalp, and mucosae (all!).
10. Past History
- Any medication received recently should be
noted, including regular or intermittent self medication.
-Any past illness (medical, surgical) and therapy,
thereof, are important in drug eruptions.
- History of medical disorders like diabetes,
hypertension, tuberculosis, seizures etc
-The dermatosis could be a manifestation of the
disease or could be an adverse effect of the drug
used to treat the disease.
-Past exposure to Mycobacterium tuberculosis
is important, when cutaneous tuberculosis is
suspected.
11. Family History
Family history is important in patients with:
Genetic disorders like ichthiosis, neurofibromatosis
and epidermolysis bullosa.
Infections and infestations, e.g., scabies, pediculosis.
Families who are exposed to similar environmental
influences may also develop same problems e.g.,
arsenical keratoses.
12. Other History
Social, occupational, travel and recreational history
may help the physician in reaching a diagnosis.
13. ERUPTIONS description and
terminology
Macules- not raised above the skin(less then 0.5 cm)
Patches- not raised above the skin- more than 0.5 cm
Papules- raised tiny eruption felt on skin( less than 0.5 cm)
Nodules- raised, firm eruption more than 0.5 cm
Tumour- raised, firm eruption more than 5 cm
Vesicles- an elevated horny layer of the epidermis by collection of
transparent or milky fluid within it which is less than 0.5 cm in size
Eg. Chicken pox, herpes zoster, small-pox
Bulla- more than 0.5 cm
Pustules- vesicles contain pus
14. Plaque- a larged,>1 cm , flat topped, raised lesion
which is indurated
Wheal- a raised erythematous , oedematous eruption
due to short lived vasodilatation and vasopermeability
Telangiactasis- a dilated superficial blood vessel
15. Macules
Macule is a circumscribed, flat lesion of skin,
which is visible because of a change in skin
Color .
> Not felt, as no change in skin texture.
> Macules may be well-defined or ill-defined and
may be of any size.
> A macule may be: Hyperpigmenteor or hypopigmented
eg., fixed drug eruption, caféau lait macule .
>Hyperpigmented macules may be Brown, if the melanin
pigment is present in the epidermis, e.g., café au lait
macule.
16.
17.
18. Slate gray or violaceous, if melanin is
present in dermis e.g.Mongolian spot.
Brownish grey, if melanin is present both
in the epidermis and dermis, e.g., nevus of
Ota (some patients).
Hypopigmented: when the lesion is less pigmented
than the surrounding skin, e.g., leprosy.
If the lesion is completely devoid of
pigment it is labelled as depigmented, e.g,
vitiligo , piebaldism.
19. papules
Small, solid, elevated lesion, <0.5 cm in diameter
(Fig. 2.3). A major portion of the papule projects above the
skin.
Papules can be due to:
Hyperplasia of cellular components of epidermis
or dermis.
Metabolic deposits in dermis.
Cellular infiltrate in dermis.
Papules may be surmounted by scales or crusts
and may evolve into vesicles and pustules.
23. Plaques
An area of altered consistency of skin which
is usually elevated, but can be depressed or
flushed with surrounding skin.
Are formed either by enlargement of individual
papules or their confluence.
Plaques may be discoid (uniformly
thickened) or annular (ring shaped). Annular
plaques can form either when center of a
discoid plaque clears or due to confluence of
papules.
24. Excoriation- linear angular erosion that may be
covered by crust and are caused by scratching
Atrophy- an aquired loss of substance( loss of dermal
or subcutaneus tissue with intact epidermis) or shiny,
delicate, wrinkled lesion(epidermal atrophy)
Scar- a change in skin secondary to trauma or
inflammation or surgery
35. Burrow: Is pathognomonic lesion of scabies.
Appears as a serpentine, thread-like, grayish (or
darker) curvilinear lesion, varying in length from
a few millimeters to a centimeter.
The open end is marked by a papule. The burrow
may be difficult to discern in dark-skinned
individuals.
Comedones: Comedones are inspissated
plugs of keratin and sebum wedged in dilated
pilosebaceous orifices. Comedones are typically
36. present in acne vulgaris, in nevus comedonicus
and in senile comedones. There are two types
of comedones:
Open comedone: black head, in which the
keratinous plug is black
Closed comedone: white head, in which the
plug is covered by skin, so the lesion appears
as a white shiny papule
41. Cyst – a soft , raised cencapsulated lesion filled with
semisolid or liquid contents
Herpetiform- grouped lesion
Lichenoid- violaceous to purple , polygonal lesion seen
in lichen planus
Milia- small firm,while papule filled with keratin
Morbilliform- generalized , small erythematous
macules, papules seen in measles
Nummular coin shaped eruption
Polycyclic- a configuration of lesion formed from
coalescing ring or incomplete rings.
43. Haemorrhage causind skin
changes
Petechiae- Tiny less than 1mm in diameter.
Purpura- 2-5 mm in diameter
Echymosis- more than 5 mm in diameter
Hematoma-haemorrhage large enough to produce elevation of the
skin.
Causes-Deficiency-scurvy
Infection-meningococcal meningitis
bacterial endocarditis
Haematological- leukemia
thrombocytopenia
aplastic anemia
44. examination
Environment for Examination
Examine patients in natural lighting. Oblique
lighting may be necessary to detect subtle elevation
of lesions, while subdued lighting enhances
subtle changes in pigmentation.
Expose the area affected and do not hesitate
to ask the patient to undress if need be (in
the presence of an attendant, if required). Do
not let stubbornness, shyness or the sex of the
patient put you off!
Remove make-up if necessary.
Magnification: An ordinary magnifying glass
(5×, 10×) can provide much needed information.
45. Examination
Skin lesions have to be described in three terms:
Morphology – macules, papules etc
Distribution.
Configuration.
Also always remember to examine nails, hair (and
scalp) and mucosae (oral, genital and nasal).
46. Look for the colour, pigmentation, hypo pigmentation, eruptions,
haemorrhage etc.
Colour- It may be pale, flushed, cyanosed or yellow.
Hypo pigmentation- leprosy
- leucoderma
- Albinism
- Tinea versicolar
68. HAIRS
Falling of hairs- Anemia
Infection
Patchy hair loss- Alopecia areata,
Syphilis
Tinea capites
Loss of outer third of the eyebrow- Leprosy
Myxoedema
Absence of axillary, pubic and facial hair-
Hypopitutarisum
Hypogonadism
Excess of body hair growth in women-
Adrenocortical syndrome
Cushing syndrome
75. Nails
Pallor
Koilonychias- spoon shaped nail due to iron deficiency
anemia
Onychia- deformity of nails due to fungal infection
Discoloration- due to Reynaud's disease, mercury and
silver poisoning
Clubbing
Haemorrhages- sub acute bacterial endocarditic,
bleeding disorder, injury.
Trophic changes- ribbing, brittleness, falling of nail
occurs in syringomyelia, leprosy, tabes dorsalis.
76. Investigation
Tzanck smear- a fresh bulla is chosen and cleaned
with spirit. The bullae is derooofed and its contents
are drained. The base of the blister is scraped with the
blunt edge of the sterile sergical blade and contents
are shifted on sterile glass slide.smea is prepared in
circular motion along one direction which is dried and
heat fixed. It is then stained with Geimsa stain. The
slide is then examined undere emersion field.
Acantholytic cells are seen in pemphigus, herpes
zoster, chicken pox etc
Wood lamp-produces long wave UVL
Tinea versicolor/ tinea capitis- yellow green
Vitiligo-milky white
77. skin biopsy – it can be carried out by taking a tiny bit-
0.4mm to 0.6 mm of affected part. Specimen is
transferred to formalin for sectioning and staining.
Fungal scraping- dermatophytes or yeast are scraped
with the help of clean ,sterile blade from margin of
lesion. The content are transferred to a drop of 10%
KOH kept on sterile glass slide. Nail are also soaked
overnight in 20% KOH before microscopic
examination. Fungal hair infection can be tested inb
same mannere.
78. Slit- smear examination- useful in case of M leprae
infection. Prepared from ear lobes, eyebrows or from
skin lesions. The area is gently scraped from the
margin of the blade after cleansing with spirit. It is air
dried and heat fixed and then stained with Z-N stain. It
is examined under the oil emersion lens for
microbacteria.
79. Diascopy- a clean glass slide which is used for light
microscopy is taken and pressed up on lesion.
Useful for- lupus vulgaris, granuloma annulare will
show apple jelly nodules which appear brownish
yellow to golden in hue.
Also in psoriasis to visualise Auspitz’s sign.
80. Dermatoscopy- useful to examine pigmented moles,
skin neoplasm, hair disorders, haemangioma etc.