Psoriasis

 

* The diagnosis is clinical; histological examination is rarely necessary (atypical or complicated shapes)

* Sign of bloody dew after scraping with a curette (a sign of Auspitz)

* Psoriasis predominantly affects extensor surfaces of the limbs (elbows, knees), the lumbosacral area and scalp. On members lesions are usually symmetrical.

* Pruritus was observed in ⅓ of cases.

* Nummular Psoriasis: midsize psoriasis lesions

* At the scalp lesions resembling pityriasis capitis simple but erythematous base straightens diagnosis. Usually the scalp psoriasis does not cause residual alopecia.

* The face is rarely achieved in isolation

* Achievement of folds is a chronic intertrigo (inverse psoriasis); erythematous lesion no or little flaky.

* The achievement of the nail (⅓ of cases) pitting; peri-Nail involvement is often associated (paronychia erythematous scaly)

* Achievement of mucous: On language: it can be a fissured tongue, or geographical. Exfoliative glossitis.Achievement possible penis …

* Psoriasis on old scar is frequently (Koebner phenomenon)

* The child is often psoriasis psoriasis gout, acute onset which followed willingly angina. The involvement of the face is common.

* Psoriasis during HIV infection presents more severe and extended forms.

Psoriasis

Psoriasis

Histology:

– Parakeratotic hyperkeratosis (stratum corneum ++)

– Disappearance of the granular layer

– ++ Thickness of the epidermis (acanthosis) with elongation of dermal papillae (papillomatosis).

– PNN grouped in small clusters in the surface layers of the epidermis (pseudo-abscesses of Munro-Sabouraud)

* Seborrheic dermatitis is a problem especially in diagnostic maps of the scalp or face. Psoriasiform secondary syphilitic (copper character ring appearance dander, infiltration wheal)

* Systemic corticosteroids may cause a severe or complicated further, especially at weaning

* Other drugs that can aggravate (or trigger) psoriasis: lithium, beta blockers, chloroquine, interferon-α.

* Other triggering factors: psychological trauma; skin trauma; bacterial infections (streptococcal infections in children)

* The prognosis can be set into play in cases of generalized pustular psoriasis or in case of psoriatic erythroderma (edematous form).

* Psoriatic arthritis: 20% of psoriasis; the progression of joint flare is independent of skin breakouts. The axial psoriatic arthritis is rare (as peripheral arthritis).

* Extra Psoriasis is an excellent indication of phototherapy. In adults PUVA is offered as first line; in children and pregnant women is UVB phototherapy.

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