Dermatology, Psoriasis, Definition, Etiology, etiopathogenesis, Clinical Manifestations, Diagnosis, Pharmacological and non pharmacological treatment.

1. DERMATOLOGY
PSORIASIS
A PRESENTATION BY:
AMAN KUMAR
LECTURER
GCRG COLLEGE OF PHARMACY

2. DERMATOLOGY
Dermatology is the science that is concerned with the diagnosis and treatment of diseases of the skin, hair and nails.
Skin diseases are conditions that affect your skin.
These diseases may cause rashes, inflammation, itchiness or other skin changes.
Some skin conditions may be genetic, while lifestyle factors may cause others.
Following are some common skin disorders:
• Acne.
• Psoriasis.
• Eczema.
• Scabies.
• Skin cancer.

3. PSORIASIS
Psoriasis = derived from Greek word psora = meaning- Itching.
• Psoriasis is a chronic non-infectious inflammatory disease of the skin.
• In this disease, epidermal cells are produced at a rate that is about six to nine times faster than normal.
• It is an inflammatory skin disease in which the skin cell replicate at an extremely rapid rate.
• New cells are produced six to nine times faster than normal but the rate at which old cells are discarded is unchanged.
• This causes the dead cells to build up on skin surface, forming thick patches or plaque of red sores, covered with flaky,
very white dead skin cells (scale).
• Psoriasis results due to rapid build up of rough, dead skin cells.
• These skin cells accumulate, forming thick silvery scales and dry, red patches that are sometimes itchy or painful.
• In some cases, pus-filled blisters appear on the skin.

6. ETIOLOGY
The cause of psoriasis is unclear (idiopathic cause) but it involves immune stimulation of epidermal keratinocytes.
T cells seem to play a central role in the development of psoriasis.
Some of the factors that may trigger psoriasis:
1. Genetics: Family history is common, and certain genes are associated with psoriasis.
2. Infection: HIV infection, streptococcal infection leading to psoriasis.
3. Injury to skin
4. Changes in climate: An environmental trigger is thought to evoke an inflammatory response and subsequent
hyperproliferation of keratinocytes.
5. Sunburn.
6. Medications: Drugs especially beta-blockers, chloroquine, angiotensin converting enzyme inhibitors, indomethacin,
terbinafine, and other allergic medicines may also sometimes lead to psoriasis.

7. PATHOPHYSIOLOGY
There are two pathophysiological mechanism behind Psoriasis.
1. First Hypothesis:
Hyperproliferation ( excessive growth) and over-activation of epidermal cells and keratinocytes due to unknown
reasons.
Rate of production of new cells increases but the discard rate of cells remains unchanged.
As a result, dead cells begins to accumulate on the skin.
Leading to formation of patches or plaques of red sores, flaky, dry, itchy and painful blisters.
PSORIASIS.

8. PATHOPHYSIOLOGY
2. Second hypothesis:
Autoimmune reaction, Genetics & Medication causes.
Hyperactivation of T cells.
T cells migrates to dermis layer.
Release of Inflammatory chemicals (Interleukin, TNF etc).
Inflammation leading to swelling, painful and itchy pus filled blisters.
PSORIASIS

9. CLINICAL MANIFESTATIONS
• Dry, swollen and inflamed patches.
• Patches covered with white flakes.
• Raised and thick skin.
• Pain, itching and burning sensation.
• Cracked and bleeding skin.
• Dandruff on scalp.
• Pus-filled blisters.
• Yellow, discoloured nails.

10. DIAGNOSIS
1. History collection and physical examination: To diagnose
psoriasis, a dermatologist will examine your skin, nails, and scalp
for signs of the disease. Dermatologist may also ask if you have
any symptoms, such as itchy skin, joint problems, such as pain and
swelling.
2. Skin biopsy: Microscopic examination of tissues.

11. TREATMENT
The standard treatment of psoriasis include:
1. Topical therapy
2. Intralesional therapy
3. Photochemo therapy
4. Systemic therapy
Topical therapy:
• The most important principle of psoriasis treatment is gentle removal of scales.
• This can be accomplished with baths.
• Oils (eg. olive oil, mineral oil) or coal tar preparations (eg. balnetar) can be added to the bath water and a soft
brush used to scrub the psoriatic plaques gently.

12. TREATMENT
Intralesional therapy:
• Injections into highly visible isolated patches of psoriasis that are resistant.
• Triamcinolone acetonide is injected and care is taken so that normal skin is not affected.
Systemic therapy:
• Methotrexate have been used in treating extensive psoriasis that fails to respond to other forms of therapy.
• It inhibits dna synthesis in epidermal cells and thus reducing the epidermopoesis (excessive production of
epidermal cells).
Photochemo therapy:
• A treatment for severe psoriasis is psoralen and ultraviolet A (PUVA) therapy which involves taking a
photosensitizing drug (usually 8- methoxypsoralen) in a standard dose with subsequent exposure to long
wave ultraviolet light to treat psoriasis.

13. THANK
YOU