Psoriasis is an autoimmune disease that causes skin cells to grow rapidly, resulting in scaling and inflammation. There are five main types, with plaque psoriasis being the most common. It is not contagious. Psoriasis has genetic and environmental triggers and can affect the skin, nails and joints. Diagnosis is usually based on visual inspection, and treatment depends on severity, ranging from topical agents for mild cases to phototherapy or systemic drugs for more severe psoriasis. Psoriasis has no cure and typically lasts a lifetime, but treatment can control symptoms.

1. Dr IMRANA TANVIR

2.  An autoimmune disease that appears on
the skin.
 It occurs when the immune system
mistakes the skin cells as a pathogen,
and sends out faulty signals that speed
up the growth cycle of skin cells.
 Psoriasis is not contagious

3. Five types of psoriasis:
 Plaque.
 Guttate.
 Inverse.
 Pustular.
 Erythrodermic.
 The most common form, plaque psoriasis, is
commonly seen as red and white hues of scaly
patches appearing on the top first layer of the
epidermis.
 Some patients, have no dermatological
symptoms.

4.  In plaque psoriasis, skin rapidly
accumulates at these sites, which gives it a
silvery-white appearance.
 Plaques frequently occur on the skin of the
elbows and knees.
 It can affect any area, including the scalp,
palms of hands and soles of feet, and
genitals.
 In contrast to eczema, psoriasis is more
likely to be found on the outer side of the
joint.

5. A person whose back and arms
are affected by psoriasis

6.  Fingernails and toenails are frequently
affected (psoriatic nail dystrophy)
 Can be seen as an isolated symptom.
 Psoriasis can also cause inflammation
of the joints, which is known as psoriatic
arthritis. Between 10-30% of all people
with psoriasis also have psoriatic
arthritis.

8. CAUSES
 Cause of psoriasis is not fully understood,
but it is believed to have a genetic
component and local psoriatic changes can
be triggered by an injury to the skin known
as the Koebner phenomenon.
 Various environmental factors have been
suggested as aggravating psoriasis,
including stress, withdrawal of systemic
corticosteroid,
 But few have shown statistical
significance.

9. CLASSIFICATION
 Nonpustular
 Psoriasis vulgaris (chronic stationary
psoriasis, plaque-like psoriasis)
 The most common form of psoriasis.
 It affects 80 to 90% of people with
psoriasis.
 Plaque psoriasis typically appears as
raised areas of inflamed skin covered with
silvery white scaly skin. These areas are
called plaques.

10.  Psoriatic erythroderma (erythrodermic psoriasis)
involves the widespread inflammation and exfoliation
of the skin over most of the body surface.
 It may be accompanied by severe itching, swelling
and pain.
 It is often the result of an exacerbation of unstable
plaque psoriasis, particularly following the abrupt
withdrawal of systemic treatment.
 This form of psoriasis can be fatal, as the extreme
inflammation and exfoliation disrupt the body's ability
to regulate temperature and for the skin to perform
barrier functions

11.  Pustular
 Pustular psoriasis appears as raised
bumps that are filled with noninfectious pus
(pustules).
 The skin under and surrounding the
pustules is red and tender.
 Pustular psoriasis can be localised,
commonly to the hands and feet
(palmoplantar pustulosis
 Generalised with widespread patches
occurring on any part of the body

12.  Additional types of psoriasis include
 Drug-induced psoriasis
 Inverse psoriasis
 Seborrheic-like psoriasis
 Napkin psoriasis

13. Plaque of psoriasis

15. Diagnosis
 Is usually based on the appearance of the
skin;
 There are no special blood tests or diagnostic
procedures.
 Sometimes, a skin biopsy, or scraping, 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 (Auspitz's sign).

17. Management
 Typically topical agents are used for mild
disease.
 Phototherapy for moderate disease.
 Systemic agents for severe disease.

18. Prognosis
 Psoriasis is typically a lifelong condition.
 There is currently no cure.
 Various treatments can help to control the
symptoms. Many of the most effective agents
used to treat severe psoriasis carry an
increased risk of significant morbidity including
skin cancers, lymphoma and liver disease.
 The majority of people's experience of
psoriasis is that of minor localized patches,
particularly on the elbows and knees, which
can be treated with topical medication.
 Psoriasis can get worse over time.