by Revival Medical Clinic

Impact of Psoriasis

  • Psoriasis is one of the commonest dermatoses
  • Unlike atopic eczema, there is no evidence that psoriasis is becoming more prevalent.
  • Average age of onset of psoriasis is in the mid twenties although it appears at a younger age in women, maybe by 3-4 years.
  • Second peak of incidence is between the ages of 55-60 years
  • 75% occur before the age of 40 years
  • Seborrhoeic dermatitis appears to be more prevalent in families of patients with psoriasis
  • 30% of patients with chronic plaque psoriasis have a family member with the disease
  • 72% concordance in monozygotic twins and 30% in dizygotes

Clinical Features of Psoriasis

  1. Chronic plaque
  2. Palmoplantar pustulosis
  3. Guttate
  4. Erythrodermic
  5. Generalised pustular

Commonest Sites

  • Scalp
  • Extensor surfaces of elbows and knees
  • Lumbo-sacral region
  • Flexures of genitalia

Other Involvements

  • Nails
  • Joints
  • Cardiovascular risk
  • Other auto-immune disease

Treatment

  1. Early detection, aggressive prevention through control of environmental factors and tight control of disease can halt the ‘metabolic march’ in psoriasis such as atopic dermatitis.
  2. 70% mild cases can be treated with topical treatments
  3. Goal of treatment is to reduce the extent or severity of psoriasis to such a level that it allows the patient to carry out their daily activities in an unhindered fashion.
  4. Psoriasis is a chronic disease which is currently incurable.
  5. Maintenance of long term patient safety will be the key to success of future treatments.

Common Topical Treatment

  1. Coal Tar
  2. Dithranol (Anthralin)
  3. Topical Corticosteroids
  4. Vitamin D3 Analogues
  5. Topical Retinoids
  6. Calcineurin Inhibitors

Second Line Treatment

  1. Phototherapy
  2. Methotrexate
  3. Ciclosporin
  4. Systemic Retinoids
  5. Hydroxyurea
  6. Azathioprine
  7. Mycophenolate Mofetil
  8. Biologics Therapies
  9. Stem Cell Therapies
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