Psoriasis causes and treatment
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Psoriasis
Today we are going to discuss a skin disease that can occur at any age from birth to old age. This skin disease is called psoriasis.
It is a skin disease in which red spots start appearing on the skin. Due to which the skin becomes very dry, it has severe itching and stinging. Initially, the drought is mild but over time it increases.
What is psoriasis?
Psoriasis is a common benign, chronic inflammatory skin disease with both a genetic basis and known environmental triggers.
Psoriasis has several variants-the most common is the plaque type. Eruptive (guttate) psoriasis consisting of myriad lesions 3-10 mm in diameter occurs occasionally after streptocoCcal pharyngitis.
* Clinical Findings :
There are often no symptoms, but itching may occur and be severe. Favoured sites include the scalp, elbows, knees, palms and soles, and nails. The lesions are red, sharply defined plaques covered with silvery scales.
The glans penis and vulva may be affected. Occasionally, only the flexures (axillae, inguinal areas) are involved. Fine stippling in the nails is highly suggestive of minimal findings elsewhere.
The psychosocial impact of psoriasis is a major factor in determining the treatment of the patient.
*Limited Disease :
For patients with numerous small plaques, phototherapy is the best therapy (see below). For patients with large plaques and < 3% of the BSA involved, the easiest regimen is to use a high-potency to ultra-high-potency topical cor-therapy corticosteroid cream or ointment.
It is best to restrict the ultra-high-potency corticosteroids to 2-3 weeks of twice-daily use and then use them in a pulse fashion three or four times on weekends or switch to a mid potency corticosteroid. Topical corticosteroids rarely induce a lasting remission.
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Symptoms of psoriasis
* Red skin patches with scales on elbow, scalp, knees hips or low back.
* Patches appear on eyebrows, armpits, belly, between hips or around the anus.
* Painful and swollen joints
* Misshapen and pitted fingernails
* Itching and pain in patches
Causes of psoriasis
There are many causes:
- Genetic
- Severe stress
- Trauma
- Environmental triggers
- Infections
- Alcohol or smoking
- Drinking less water
- Infection
- Medication
Diagnosis of psoriasis
Remember that psoriasis is very easy to diagnose because of its specific symptoms doctors can easily diagnose it during a physical examination.
Treatment of psoriasis
Psoriasis can be treated in 5 months to 5 years. If someone is overweight, they should lose weight along with the treatment as soon as the medicines work well.
There are many therapeutic options in psoriasis to be chosen according to the extent (body surface area [BSA]affected) and the presence of other findings (for example, arthritis). Certain drugs, such as beta-blockers, antimalarials. statins, and lithium, may flare or worsen psoriasis.
Even tiny doses of systemic corticosteroids given to patients with psoriasis may lead to severe rebound flares of their disease when they are tapered.
Initially, patients are treated with twice-daily corticosteroids plus a vitamin D analogue twice daily. This rapidly clears the lesions.
The vitamin D analogue is then used alone once daily and with the corticosteroid once daily for several weeks. Eventually, the topical corticosteroids are stopped, and once or twice daily application of the vitamin D analogue is continued long-term.
Treatment of extensive psoriasis with vitamin D analogues may result in hypercalcemia so that the maximum dose for calcipotriene is 100 g/week and for calcitriol is 200 g/week.
Calcipotriene is incompatible with many topical corticosteroids (but not halobetasol), so if used concurrently it must be applied at a different time. Tar preparations such as Fototar cream, LCD (liquor carbon detergent) 10% in Nutraderm lotion, alone or mixed directly with triamcinolone 0.1%, are useful adjuncts when applied twice daily.
For the scalp, start with a tar shampoo, used daily if possible. For thick scales, use 6% salicylic acid gel (eg, Keralyt), P & S solution (phenol, mineral oil, and glycerin)or fluocinolone acetonide 0.01% in oil (Derma-Smoothe/ FS) under a shower cap at night, and shampoo in the morning.
In order of increasing potency, triamcinolone 0.1%, or fluocinolone, betamethasone dipropionate, fluocinonide or amcinonide, and clobetasol are available in solution form for use on the scalp twice daily.
* Moderate Disease :
Psoriasis affecting 3-10% of the patient's BSA is frequently treated with UV phototherapy, either in a medical office or via a home light unit. Systemic agents listed below may also be used.
* Generalized Disease :
If psoriasis involves> 10% of the body surface, it is difficult to treat with topical agents. The treatment of choice is outpatient narrowband UVB (NB-UVB) three times weekly. Clearing occurs in an average of 7 weeks, but maintenance may be required.
Methotrexate is very effective for severe psoriasis in doses up to 25 mg once weekly. It should be used according to published protocols. Long-term methotrexate use may be associated with cirrhosis.
Acitretin, a synthetic retinoid, is most effective for pustular psoriasis in dosages of 0.5-0.75 mg/kg/d. Liver enzymes and serum lipids must be checked periodically. Because acitretin is a teratogen and persists for long periods in fat, women of childbearing age must wait at least 3 years after and completing acitretin treatment before considering pregnancy.
Cyclosporine dramatically improves psoriasis and may be used to control severe cases. Rapid relapse (rebound) is the rule after cessation of therapy, so another agent must be added if cyclosporine is stopped.
Etanercept is used more frequently for long-term treatment at a dose of 50 mg twice weekly for 3 months, then 50 mg once weekly.
Not every doctor can treat psoriasis, so the patient should only have a check-up by a dermatologist. Always use standard bath products, and if possible, dry your body in the sun after bathing. Always apply moisturizers on the skin after bathing.
Reduce the use of dairy products in psoriasis and increase the consumption of fruits, especially eat food containing vitamin D.
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