The document discusses psoriasis, a chronic, non-infectious skin condition characterized by erythematous plaques and silvery scales. It highlights its incidence, common triggers, and the pathogenesis involving immune reactions and cytokine transcription regulation. Additionally, it outlines histopathological changes and the role of lymphocytes in the disease process.

1. Psoriasiform Lesions

2. Some things common

3. Epidermal hyperplasia

6. Elongation of rete ridges

8. Psoriasis

9. Psoriasis Greek word for 'itch'

10. “ chronic non-infectious erythematous plaques & papules silvery scales extensor distribution”

11. Psoriasis vulgaris (common) Chronic Relapsing Papulosquamous dermatitis

12. Incidence : 2 % All Races More in western people Mean age - 25 yrs

13. Chr - 6P21.3 Associated with - HLA-CW0602 (PCR)

14. How the patient presents ?

15. Erythematous plaques with Silver scaling

16. When the scales are removed …

17. Auspitz’s sign It bleeds

18. Capillaries Scratch

19. Which sites are involved ?

29. Scalp , Lips no involved Oral lesions are rare

30. 5 % cases --- Polyarthritis

31. Do we know the Cause ? 

32. Trigger factors Trauma Infection Drugs : Lithium, iodine , B blockers, Carbamazepine, NSAIDS, ACE inhibitors Climate Hormone, Stress Alcohol Smoking

33. Lesions after Trauma (Koebner phenomenon) 30 % cases.

34. What is the Pathogenesis ?

35. Y Y Y Its an Immune reaction

36. “Problem in signal transduction” Initiation

37. Cytokine transcription regulation problems

38. Stimulation of immunity by super antigen

39. Problem in signal transduction in between the cells Cytokine transcription regulation problems Stimulation of immunity by super antigen Initiation

40. Blood vessels in the papillary dermis Disease process starts here

41. Blood vessels in the papillary dermis Dilatation and tortuosity

42. Angiogenesis (TGF alfa, IL 8 ) Size of microcirculation Expands New vessels bring T lymphocytes

43. Lymphocyte recruitment in papillary dermis (PAF, LB4) Lymphocytes come and bind to endothelial cells in venules of papillary dermis

44. Even the expression of adhesion molecules is increased (E selectin)

45. E selectin correlates with the disease process UV rays decrease adhesion molecules! ( PUVA therapy !!)

46. Now the Lymphocytes come out of the venules (C5a)

47. CD4 or CD8 ? CD4 in the dermis CD8 migrate to the epidermis

48. Mechanism T cell activation by super antigen Release of huge quantity of cytokines

49. Transit time change 53 days

50. in Psoriasis 7 days

51. Histopathology

52. Early changes Dilatation and congestion of vessels Mild perivascular lymphocytic infiltration