The document discusses psoriasis, a skin disease that causes red, scaly patches. It affects the skin and joints. The scaly patches are areas of inflammation and excessive skin production. Psoriasis is caused by skin cells replicating too quickly, building up on the skin's surface. There are various types of psoriasis affecting different areas of the body. Treatment involves topical creams and ointments, phototherapy using UV light, and systemic medications for more severe cases.
Rosacea is a chronic (long-term) disease
that affects the skin and sometimes the eyes. The disorder is characterized by
redness, pimples, and, in advanced stages, thickened skin. Rosacea usually
affects the face. Skin on other parts of the upper body is only rarely
involved.
Rosacea is a chronic (long-term) disease
that affects the skin and sometimes the eyes. The disorder is characterized by
redness, pimples, and, in advanced stages, thickened skin. Rosacea usually
affects the face. Skin on other parts of the upper body is only rarely
involved.
INTRODUCTION OF PSORIASIS, EPIDEMIOLOGY OF PSORIASIS, CLINICAL FEATURES OF PSORIASIS, PROGNOSIS OF PSORIASIS, HISTOPATHOLOGY OF PSORIASIS, TRIGGERING FACTORS OF PSORIASIS, PATHOGENESIS OF PSORIASIS
The word Psoriasis is derived from Greek word ‘Psora’ means itching.
Psoriasis is a chronic skin disease results in patches of thick red skin covered with the silvery scales.
It affect approximately 2% of the population.
It occurs in any age group, most commonly occur in people between 15 – 35 years of age.
Viral infections of the skin
DIRECT INFECTIONS ON THE SKIN
→Molluscum Contagiosum
→Wart
SKIN MANIFESTATIONS OF SYSTEMIC DISEASES
Vesicular:Hand foot mouth disease,chicken pox,HSV 1,2
Non vesicular:Measles,Rubella and other exanthematous
rashes.
Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp. Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission
INTRODUCTION OF PSORIASIS, EPIDEMIOLOGY OF PSORIASIS, CLINICAL FEATURES OF PSORIASIS, PROGNOSIS OF PSORIASIS, HISTOPATHOLOGY OF PSORIASIS, TRIGGERING FACTORS OF PSORIASIS, PATHOGENESIS OF PSORIASIS
The word Psoriasis is derived from Greek word ‘Psora’ means itching.
Psoriasis is a chronic skin disease results in patches of thick red skin covered with the silvery scales.
It affect approximately 2% of the population.
It occurs in any age group, most commonly occur in people between 15 – 35 years of age.
Viral infections of the skin
DIRECT INFECTIONS ON THE SKIN
→Molluscum Contagiosum
→Wart
SKIN MANIFESTATIONS OF SYSTEMIC DISEASES
Vesicular:Hand foot mouth disease,chicken pox,HSV 1,2
Non vesicular:Measles,Rubella and other exanthematous
rashes.
Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp. Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission
Skin Ailments Psoriasis By Dr. Darbha Aneeta
This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com.
Kayakalp is a well-known Skin Care Center for Psoriasis Treatment in Delhi-India with a lot of success records in curing Psoriasis - a challenge for medical community.
http://www.kayakalpglobal.com/psoriasis-treatment-delhi-india.html
Homeopathy treatment offers a long-term cure for Psoriasis. Find common homeopathy medicines which give a remarkable result in the Psoriasis problem. Visit Multicare Homeopathy.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. PsoriasisPsoriasis is a disease whichis a disease which
affects theaffects the skinskin andand jointsjoints..
It commonly causes red scalyIt commonly causes red scaly
patches to appear on the skin.patches to appear on the skin.
The scaly patches caused byThe scaly patches caused by
psoriasis, called psoriaticpsoriasis, called psoriatic
plaques, are areas ofplaques, are areas of
inflammation and excessiveinflammation and excessive
skin production.skin production.
Skin rapidly accumulates atSkin rapidly accumulates at
these sites and takes a silvery-these sites and takes a silvery-
white appearance.white appearance.
Plaques frequently occur on thePlaques frequently occur on the
skin of the elbows and knees,skin of the elbows and knees,
but can affect any areabut can affect any area
including the scalp and genitals.including the scalp and genitals.
2
3. Psoriasis is an inflammatory skin disease in which skin cellsPsoriasis is an inflammatory skin disease in which skin cells
replicate at an extremely rapid rate. New skin cells are producedreplicate at an extremely rapid rate. New skin cells are produced
about eight times faster than normal--over several days instead ofabout eight times faster than normal--over several days instead of
a month--but the rate at which old cells slough off is unchanged.a month--but the rate at which old cells slough off is unchanged.
This causes cells to build up on the skin's surface, forming thickThis causes cells to build up on the skin's surface, forming thick
patches, or plaques, of red sores (lesions) covered with flaky,patches, or plaques, of red sores (lesions) covered with flaky,
silvery-white dead skin cells (scales).silvery-white dead skin cells (scales).
3
4. The disorder is a chronic recurring conditionThe disorder is a chronic recurring condition
which varies in severity from minor localisedwhich varies in severity from minor localised
patches to complete body coverage.patches to complete body coverage.
Fingernails and toenails are frequently affectedFingernails and toenails are frequently affected
(psoriatic nail dystrophy) - and can be seen as an(psoriatic nail dystrophy) - and can be seen as an
isolated finding.isolated finding.
Psoriasis can also cause inflammation of thePsoriasis can also cause inflammation of the
joints, which is known asjoints, which is known as psoriatic arthritispsoriatic arthritis..
4
5. The cause of psoriasis is not known, but it is believedThe cause of psoriasis is not known, but it is believed
to have a genetic component.to have a genetic component.
Several factors are thought to aggravate psoriasis.Several factors are thought to aggravate psoriasis.
These includeThese include stressstress,, excessive alcohol consumptionexcessive alcohol consumption,,
andand smokingsmoking..
Individuals with psoriasis may suffer from depressionIndividuals with psoriasis may suffer from depression
and loss of self-esteem.and loss of self-esteem.
As such, quality of life is an important factor inAs such, quality of life is an important factor in
evaluating the severity of the disease.evaluating the severity of the disease.
Certain medicines, includingCertain medicines, including lithium saltlithium salt andand
beta blockersbeta blockers, have been reported to trigger or, have been reported to trigger or
aggravate the disease.aggravate the disease.
5
6. There are two main hypotheses about the process that occurs inThere are two main hypotheses about the process that occurs in
the development of the disease.the development of the disease.
The first considers psoriasis as primarily a disorder of excessiveThe first considers psoriasis as primarily a disorder of excessive
growth and reproduction of skin cells. The problem is simplygrowth and reproduction of skin cells. The problem is simply
seen as a fault of theseen as a fault of the epidermisepidermis and itsand its keratinocyteskeratinocytes..
The second hypothesis sees the disease as being anThe second hypothesis sees the disease as being an
immune-mediated disorderimmune-mediated disorder in which the excessive reproductionin which the excessive reproduction
of skin cells is secondary to factors produced by the immuneof skin cells is secondary to factors produced by the immune
system.system. T cellsT cells (which normally help protect the body against(which normally help protect the body against
infection) become active, migrate to the dermis and trigger theinfection) become active, migrate to the dermis and trigger the
release of cytokines (tumor necrosis factor-alpha TNFα, inrelease of cytokines (tumor necrosis factor-alpha TNFα, in
particular) which cause inflammation and the rapid productionparticular) which cause inflammation and the rapid production
of skin cells. It is not known what initiates the activation of the Tof skin cells. It is not known what initiates the activation of the T
cells.cells.
The immune-mediated model of psoriasis has been supported byThe immune-mediated model of psoriasis has been supported by
the observation that immunosuppressant medications can clearthe observation that immunosuppressant medications can clear
psoriasis plaques.psoriasis plaques.
6
7. Plaque psoriasisPlaque psoriasis (psoriasis vulgaris)(psoriasis vulgaris) is theis the
most common form of psoriasis. It affects 80 tomost common form of psoriasis. It affects 80 to
90% of people with psoriasis. Plaque psoriasis90% of people with psoriasis. Plaque psoriasis
typically appears as raised areas of inflamed skintypically appears as raised areas of inflamed skin
covered with silvery white scaly skin. These areascovered with silvery white scaly skin. These areas
are called plaques.are called plaques.
Types of PsoriasisTypes of Psoriasis
7
8. Flexural psoriasisFlexural psoriasis (inverse(inverse
psoriasis)psoriasis) appears as smoothappears as smooth
inflamed patches of skin. It occursinflamed patches of skin. It occurs
in skin folds, particularly aroundin skin folds, particularly around
the genitals (between the thigh andthe genitals (between the thigh and
groin), the armpits, under angroin), the armpits, under an
overweight stomach (pannus), andoverweight stomach (pannus), and
under the breasts (inframammaryunder the breasts (inframammary
fold). It is aggravated by frictionfold). It is aggravated by friction
and sweat, and is vulnerable toand sweat, and is vulnerable to
fungal infections.fungal infections.
Guttate psoriasisGuttate psoriasis is characterizedis characterized
by numerous small oval (teardrop-by numerous small oval (teardrop-
shaped) spots. These numerousshaped) spots. These numerous
spots of psoriasis appear over largespots of psoriasis appear over large
areas of the body, such as theareas of the body, such as the
trunk, limbs, and scalp. Guttatetrunk, limbs, and scalp. Guttate
psoriasis is associated withpsoriasis is associated with
streptococcal throat infectionstreptococcal throat infection
8
9. Pustular psoriasisPustular psoriasis appears as raised bumps thatappears as raised bumps that
are filled with non-infectious pus (pustules). Theare filled with non-infectious pus (pustules). The
skin under and surrounding pustules is red andskin under and surrounding pustules is red and
tender. Pustular psoriasis can be localised,tender. Pustular psoriasis can be localised,
commonly to the hands and feet , or generalisedcommonly to the hands and feet , or generalised
with widespread patches occurring randomly onwith widespread patches occurring randomly on
any part of the body.any part of the body.
9
10. Nail psoriasisNail psoriasis produces a variety of changes inproduces a variety of changes in
the appearance of finger and toe nails. Thesethe appearance of finger and toe nails. These
changes include discolouring under the nailchanges include discolouring under the nail
plate, pitting of the nails, lines going across theplate, pitting of the nails, lines going across the
nails, thickening of the skin under the nail, andnails, thickening of the skin under the nail, and
the loosening (onycholysis) and crumbling of thethe loosening (onycholysis) and crumbling of the
nail.nail.
10
13. Psoriatic arthritisPsoriatic arthritis involvesinvolves
joint and connective tissuejoint and connective tissue
inflammation.inflammation.
Psoriatic arthritis can affectPsoriatic arthritis can affect
any joint but is mostany joint but is most
common in the joints of thecommon in the joints of the
fingers and toes. This canfingers and toes. This can
result in a sausage-shapedresult in a sausage-shaped
swelling of the fingers andswelling of the fingers and
toes known as dactylitis.toes known as dactylitis.
Psoriatic arthritis can alsoPsoriatic arthritis can also
affect the hips, knees andaffect the hips, knees and
spine (spondylitis). About 10-spine (spondylitis). About 10-
15% of people who have15% of people who have
psoriasis also have psoriaticpsoriasis also have psoriatic
arthritis.arthritis.
13
14. Erythrodermic psoriasisErythrodermic psoriasis
involves the widespreadinvolves the widespread
inflammation and exfoliationinflammation and exfoliation
of the skin over most of theof the skin over most of the
body surface. It may bebody surface. It may be
accompanied by severeaccompanied by severe
itching, swelling and pain.itching, swelling and pain.
It is often the result of anIt is often the result of an
exacerbation of unstableexacerbation of unstable
plaque psoriasis, particularlyplaque psoriasis, particularly
following the abruptfollowing the abrupt
withdrawal of systemicwithdrawal of systemic
treatment. This form oftreatment. This form of
psoriasis can be fatal, as thepsoriasis can be fatal, as the
extreme inflammation andextreme inflammation and
exfoliation disrupt the body'sexfoliation disrupt the body's
ability to regulate temperatureability to regulate temperature
and for the skin to performand for the skin to perform
barrier functions.barrier functions.
14
16. A diagnosis of psoriasis is usually based on theA diagnosis of psoriasis is usually based on the
appearance of the skin. There are no specialappearance of the skin. There are no special
blood tests or diagnostic procedures forblood tests or diagnostic procedures for
psoriasis. Sometimes a skin biopsy, or scraping,psoriasis. Sometimes a skin biopsy, or scraping,
may be needed to rule out other disorders and tomay be needed to rule out other disorders and to
confirm the diagnosis. Skin from a biopsy willconfirm the diagnosis. Skin from a biopsy will
show clubbed pegs if positive for psoriasis.show clubbed pegs if positive for psoriasis.
Another sign of psoriasis is that when theAnother sign of psoriasis is that when the
plaques are scraped, one can see pinpointplaques are scraped, one can see pinpoint
bleeding from the skin below (Auspitz's sign).bleeding from the skin below (Auspitz's sign).
16
17. Treatment optionsTreatment options
There can be substantial variation between individualsThere can be substantial variation between individuals
in the effectiveness of specific psoriasis treatments.in the effectiveness of specific psoriasis treatments.
Because of this, dermatologists often use a trial-and-Because of this, dermatologists often use a trial-and-
error approach to finding the most appropriateerror approach to finding the most appropriate
treatment for their patient.treatment for their patient.
The decision to employ a particular treatment is basedThe decision to employ a particular treatment is based
on the type of psoriasis, its location, extent and severity.on the type of psoriasis, its location, extent and severity.
The patient’s age, gender, quality of life, comorbidities,The patient’s age, gender, quality of life, comorbidities,
and attitude toward risks associated with the treatmentand attitude toward risks associated with the treatment
are also taken into consideration.are also taken into consideration.
17
18. Medications with the least potential for adverseMedications with the least potential for adverse
reactions are preferentially employed.reactions are preferentially employed.
As a first step, medicated ointments or creams areAs a first step, medicated ointments or creams are
applied to the skin. If topical treatment fails to achieveapplied to the skin. If topical treatment fails to achieve
the desired goal then the next step would be to exposethe desired goal then the next step would be to expose
the skin to ultraviolet (UV) radiation. This type ofthe skin to ultraviolet (UV) radiation. This type of
treatment is called phototherapy.treatment is called phototherapy.
The third step involves the use of medications whichThe third step involves the use of medications which
are taken internally by pill or injection : systemicare taken internally by pill or injection : systemic
treatment.treatment.
Over time, psoriasis can become resistant to a specificOver time, psoriasis can become resistant to a specific
therapy. Treatments may be periodically changed totherapy. Treatments may be periodically changed to
prevent resistance developing (tachyphylaxis) and toprevent resistance developing (tachyphylaxis) and to
reduce the chance of adverse reactions occurring:reduce the chance of adverse reactions occurring:
treatment rotation.treatment rotation.
18
21. Coal TarCoal Tar
- Prefered for limited or scalp psoriasisPrefered for limited or scalp psoriasis
- Can be effective in widespread psoriasisCan be effective in widespread psoriasis
- Antimitotic, anti-pruriticAntimitotic, anti-pruritic
- No quick onset but longer remissionNo quick onset but longer remission
- Often combined with SA, UV light therapyOften combined with SA, UV light therapy
- 2 types: Crude coal tar and Liquor picis carbonis2 types: Crude coal tar and Liquor picis carbonis
21
22. DithranolDithranol
May restore normal epidermal proliferation andMay restore normal epidermal proliferation and
keratinizationkeratinization
Useful in thick plaque psoriasisUseful in thick plaque psoriasis
Commonly used with SACommonly used with SA
2 treatment approach: long contact and short2 treatment approach: long contact and short
contactcontact
Stains clothes, irritating to normal skinStains clothes, irritating to normal skin
22
23. Topical CSTopical CS
Anti-inflammatory, immunosuppressiveAnti-inflammatory, immunosuppressive
Quick onset than coal tar and dithranolQuick onset than coal tar and dithranol
Tachyphylaxis can occurTachyphylaxis can occur
High potent agents used in severe cases, thickHigh potent agents used in severe cases, thick
plaquesplaques
AE local and systemicAE local and systemic
Should not be stopped abruptly – reboundShould not be stopped abruptly – rebound
psoriasispsoriasis
23
24. PhototherapyPhototherapy
UVA, UVB, PUVAUVA, UVB, PUVA
UVB preferedUVB prefered
Administered by lamp, sunlight exposure aloneAdministered by lamp, sunlight exposure alone
or in combo with another topical agentor in combo with another topical agent
PUVA (methoxsalen) given PO 2 hours beforePUVA (methoxsalen) given PO 2 hours before
UVA or lotion applied 30mins before exposureUVA or lotion applied 30mins before exposure
AE: itch, edemaAE: itch, edema
24
25. Systemic TherapySystemic Therapy
ImmunomodulatorsImmunomodulators
- Cyclosporin, methotrexate commonly usedCyclosporin, methotrexate commonly used
- Antibiotics in case of secondary bacterialAntibiotics in case of secondary bacterial
infectionsinfections
25
26. Systemic agents are generally recommended forSystemic agents are generally recommended for
patients with moderate-to-severe disease.patients with moderate-to-severe disease.
Moderate disease is defined as greater than 5%Moderate disease is defined as greater than 5%
body-surface area involvement; severe disease isbody-surface area involvement; severe disease is
defined by greater than 10%defined by greater than 10%
26
27. Psoriasis is a lifelong condition.Psoriasis is a lifelong condition.
There is currently no cure but various treatments canThere is currently no cure but various treatments can
help to control the symptoms. Many of the mosthelp to control the symptoms. Many of the most
effective agents used to treat severe psoriasis carry aneffective agents used to treat severe psoriasis carry an
increased risk of significant morbidity including skinincreased risk of significant morbidity including skin
cancers, lymphoma and liver disease.cancers, lymphoma and liver disease.
Psoriasis does get worse over time but it is not possiblePsoriasis does get worse over time but it is not possible
to predict who will go on to develop extensiveto predict who will go on to develop extensive
psoriasis or those in whom the disease may appear topsoriasis or those in whom the disease may appear to
vanish.vanish.
Individuals will often experience flares and remissionsIndividuals will often experience flares and remissions
throughout their lives. Controlling the signs andthroughout their lives. Controlling the signs and
symptoms typically requires lifelong therapy.symptoms typically requires lifelong therapy.
SummarySummary
27