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Psoriasis clinical manifestations: A - chronic plaque psoriasis, B - guttate psoriasis, C pustular psoriasis, D - erythrodermic psoriasis (With permission of Américo Figueiredo, PhDMD, and of Hugo Oliveira, MD).
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Context 1
... other forms of psoriasis include guttate, erythrodermic and pustular psoriasis. It is characterized by papulosquamous plaques well-defined from surrounding normal skin ( Figure 1A). These plaques are red or salmon pink, covered by white or silvery scales, and the plaques may be thick, thin, large or small. ...
Context 2
... psoriasis ( Figure 1B), an acute form of psoriasis that develops especially in children, adolescents and young adults, is characterized by papules with less than 1 cm in diameter that erupt in the trunk and extremities, about 2 weeks after a -haemolytic streptococcal or a viral infection, and/or after acute stressful life events. Usually, it is self-limited, resolving in 3-4 months, however its long-term prognosis is unknown. ...
Context 3
... psoriasis ( Figure 1C) is an acute form of psoriasis, in which small, monomorphic, sterile pustules develop in painful inflamed skin. It can be generalized and potentially life- threatening or it can be localized, presenting as palmoplantar pustulosis or acrodermatitis continua of Hallopeau. ...
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... erythrodermic psoriasis ( Figure 1D), more than 90% of the skin surface area is affected, which may lead to hypothermia, due to an impairment in the thermoregulation of the skin, high output cardiac failure, infection and metabolic changes. These changes include hypoalbuminaemia and anaemia due to loss of iron, vitamin B 12 and folate. ...
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As a common dermatological disorder, psoriasis is well known to be associated with psychological morbidity. The da-tabase on this aspect from the developing countries is limited. In this prospective cross-sectional study 103 psoriasis outpatients were evaluated along with 55 healthy controls matched for sociodemographic profile and on attitude to a...
Citations
... Psoriasis influences about 3% of the population and affects men and women equally, with a 1:1 female to male ratio of (11,12). Psoriasis Vulgaris, which accounts for about 90% of all cases, is distinguished by well-defined, dark red, scaly lesions and plaques, usually appearing on the elbows, knees, scalp and other skin areas 13 . Chronic plaque is the most common type of psoriasis, accounting for approximately 70% to 80% of all patients 14 . ...
Background: psoriasis is a prevalent, persistent, non-contagious skin disorder of unknown origin or cure. It has a significant detrimental influence on people's life. It was hypothesized that there is a relation between reducing vitamin D levels and psoriasis. Psoriasis is a severe global condition that affects at least 100 million people; the incidence of psoriasis ranges from 0.09 to 11.43 %. The incidence of psoriasis is 0.09 % to 11.43 %. Objectives & Methodology: Study the frequency of and incidence of psoriasis and its correlation with serum vitamin D3 level; 150 people aged between 1-45 years old and from both sexes were selected for the current study. All of them were recruited from Hilla Teaching Hospital and TelAfer from November 2018 to February 2019 in Babylon Governorate. Of them, 50 were suffering from Psoriasis symptoms, 50 were presented with a positive family history of psoriasis, and the last 50 people were healthy and considered a control group. They were all subjected to estimating the serum level of vitamin D3 by using the ELISA technique. Results: a significant decrease in the serum level of vitamin D3 was found among patients with psoriasis compared to the control and family history groups. The study also indicates that the onset frequency of psoriasis has a hereditary component. In comparison to the age groups (1-15) and (16-30), the results showed a considerable increase in the age groups (31-45). The incidence was more in males than in females. Conclusions: A significant decrease in vitamin D3 in patients with psoriasis.
... Tidak ada perbedaan prevalensi terhadap jenis kelamin. 4,5 Etiopatogenesis penyakit ini kompleks, melibatkan faktor genetik, imunologik, dan lingkungan. Sebagian besar penelitian yang telah dilakukan fokus pada peran sitokin dan sel imun. ...
... 11,12 Meskipun demikian, sebagian besar literatur menyatakan bahwa psoriasis mempengaruhi kedua jenis kelamin secara seimbang. 4,5 Kejadian psoriasis vulgaris pada subyek kasus penelitian ini memiliki distribusi terbanyak pada kelompok usia 41-50 tahun (40%), dan terendah pada kelompok usia di atas 60 tahun (5%). Hasil yang mirip didapatkan dari penelitian yang dilakukan oleh Wardhana, di mana pasien psoriasis terbanyak terdapat pada kelompok usia 30-50 tahun (53%), dan terendah pada kelompok usia di atas 50 tahun (18%). ...
Psoriasis adalah suatu penyakit kulit kronis yang secara klasik ditandai oleh daerah kulit memerah dan menebal, ditutupi skuama keperakan. Etiopatogenesisnya kompleks, melibatkan faktor genetik, imunologik dan lingkungan. Kemungkinan adanya kontribusi neuroendokrin pada patogenesis psoriasis cukup menarik perhatian. Kortisol merupakan salah satu profil neuroendokrin yang berinteraksi dengan banyak jalur dalam mencetuskan psoriasis, antara lain regulasi kompartemen epidermis, modulasi respons imun, dan stres.Penelitian ini bertujuan untuk mengetahui perbedaan kadar kortisol dalam serum antara pasien psoriasis vulgaris dengan bukan pasien psoriasis vulgaris, menggunakan rancangan penelitian analitik dengan pendekatan potong lintang. Penelitian dilakukan sejak bulan Juni sampai Oktober 2016 di RSUP H. Adam Malik Medan. Kadar kortisol dalam serum subyek diperiksa dengan enzyme-linked immunosorbent assay (ELISA). Digunakan uji T-independen untuk menilai perbandingan kadar kortisol dalam serum antara kedua kelompok.Selama 5 bulan penelitian didapatkan 40 subyek penelitian yang terdiri atas 20 pasien psoriasis vulgaris dan 20 bukan pasien psoriasis vulgaris. Ditemukan kadar rerata kortisol yang lebih rendah dalam serum pasien psoriasis vulgaris (7,185 5,04 g/dL) dibandingkan dengan bukan pasien psoriasis vulgaris (10,390 3,74 g/dL) yang bermakna secara statistik (p<0,05).Dari penelitian ini dapat disimpulkan bahwa terdapat perbedaan yang bermakna secara statistik pada nilai rerata kadar kortisol dalam serum antara pasien psoriasis vulgaris dengan bukan pasien psoriasis vulgaris.
... The score was taken weekly from 0 to 4 by severity of the symptoms as mentioned above. 0 indicates the absence of symptoms, 1 for mild, 2 for moderate, three for severe and four as very severe (Van Der Fits et al 2009;Coimbra 2012). Statistical analysis was applied to the noted observations to draw the significance. ...
Psoriasis has become a topic of global concern because of consistency in its prevalence according to Global Report on Psoriasis 2016, however, till date, no therapy has provided complete cure of this disease and no useful measure was discovered to prevent it or eliminate the risk of its relapse. Hence, the present study was designed to evaluate anti-psoriatic effects of Spinacia oleracea due to its anti-inflammatory, anti-oxidant, anti-proliferative and skin-strengthening contents. Psoriasis was induced by oral potassium iodide solution which was then determined by two methods i.e. percentage reduction in psoriatic patch size and psoriasis area and severity index (PASI) score to measure the decrease in severity. Twenty albino rats were used in each method, grouped as standard, curative, preventive and control with five rats in each group. Therapeutic and preventive doses for S. oleracea in both the methods were calculated according to daily intake guidelines of National Cancer Institute, USA, and German Nutrition Society, DGE guidelines respectively with slight modification. Methotrexate was used as standard drug along with folic acid to avoid toxic effects. This study reveals that S. oleracea has both therapeutic and preventive effects. It may be concluded that S. oleracea can be effectively used as sole therapy for psoriasis.
... Psoriasis is a persistent, disfiguring and stigmatizing disease, that leads to psychological and emotional impact in the patients, that needs to be substantiated. 7 Psoriatic patients, not only have severe psychological disability, but they also have substantial impairment of health related quality of life. It is thought that HRQOL is more resolute by how an individual mentally handles the disease than by the amount of skin affected. ...
... Psoriasis is bimodal in onset, with two peaks at 16-22 and other at 57-60 years of age. 7 The mean age of onset of psoriasis vulgaris is 33 years. 11 But Dogra S, Savita Y et al, inferred that in India most of the patients are in their third or fourth decade at the time of presentation. ...
... It appears that, there is not always a strong correlation between the HRQOL and the severity of the disease, as defined by PASI. 7 Thus it is revealed that the clinical severity had positive correlation with psychiatric morbidity and quality of life. The patients from inpatient department showed that severe depression had moderate PASI score with high DLQI, so this revealed the fact that distortion of quality of life of psoriatic patients not only involves the clinical severity, but other factors like duration of the disease, disease chronicity, expense of treatment, moral support also influence the quality of life. ...
... Oncotarget, Advance Publications 2017 immune, infection, metabolic disorders, endocrine, nervous and mental factor [15]. Metabolic abnormalities in patients with psoriasis had received extensive attention, involving proteins, lipids, carbohydrates, vitamins and enzymes and other metabolic disorders [16][17][18][19][20][21][22][23]. ...
Psoriasis is a common, chronic, systemic inflammatory skin disease, the etiology and pathogenesis is unclear. An untargeted high-throughput metabonomics method based on liquid chromatography coupled to mass spectrometry was applied to study the serum metabolic changes in psoriasis vulgaris patients, and to discover serum potential biomarkers for identification, diagnosis and exploring pathogenesis of psoriasis. The serum metabolic profiles from 150 subjects (75 psoriasis patients and 75 healthy controls) were acquired, the raw spectrometric data were processed by multivariate statistical analysis, and 44 potential biomarkers were screened out and identified. The potential biomarkers were mainly involved in glycerophospholipid metabolism, sphingolipid metabolism, arachidonic acid metabolism, bile acid biosynthesis, indicated the pathogenesis of psoriasis may be related to the disturbed metabolic pathways.
... [1][2][3] These pathologic capillaries are very close to the epidermal-dermal junction. 4 To date, there are three modalities of treatment for psoriasis: topical therapies, systemic agents, and phototherapy. Phototherapy is chosen as an alternative, especially narrow-band UVB (NBUVB) phototherapy, due to its safer profile and more convenient administration. ...
Psoriasis is a chronic inflammatory skin disease known to be highly responsive to phototherapy. Narrow-band UVB (NBUVB) phototherapy has been one of the standard treatments for its moderate to severe form. However, its lack of efficacy in treating stable psoriatic plaques on extremities has lead researchers to find alternative treatments, one of which is pulsed-dye laser (PDL). Laser has been known to be effective in treating vascular lesions; in psoriasis, elongation of rete ridge along with tortuous dermal capillaries are one of the first pathologies identified early in the disease progression. Several in vivo and preliminary studies have found the molecular mechanism of action of laser on abnormal vessel growth. In this article, we report a psoriasis vulgaris case in adult whose lesions responded well to NBUVB phototherapy. The psoriatic plaques on her extremities were stable despite NBUVB therapy and some topical treatments afterwards. With knowledge of emerging role of PDL in inflammatory skin disease such as psoriasis, we conducted a literature search and critically appraised the resulting articles. The systematic review article found evaluates PDL efficacy as a treatment for inflammatory skin diseases, including psoriasis, and was appraised using a worksheet from British Medical Journal Evidence-Based Medicine Toolkit. Its validity, importance, and applicability aspects were evaluated, leading to a conclusion that PDL can be used as an alternative treatment for psoriasis plaques in trunks, extremities, hands, or feet (both stable and unstable), with minimal and transient side effects (hyperpigmentation, hypopigmentation, and blistering).
... The diagnosis of psoriasis sometimes relies on skin biopsies for histopathological evaluation. There are several visual-assessment based approaches for measuring the severity of psoriasis, such as Psoriasis Area and Severity Index (PASI), National Psoriasis Foundation Psoriasis Score (NPF-PS), Physician's Global Assessment (PGA), Lattice System Physician's Global Assessment (LS-PGA) [12, 13]. Among them, the PASI scoring system is the most commonly used by dermatologists in Taiwan since it is the scoring system suggested by Taiwan National Health Insurance Administration. ...
Diffuse reflectance spectroscopy (DRS) has been utilized to study biological tissues for a variety of applications. However, many DRS systems are not designed for handheld use and/or relatively expensive which limit the extensive clinical use of this technique. In this paper, we report a handheld, low-cost DRS system consisting of a light source, optical switch, and a spectrometer, that can precisely quantify the optical properties of tissue samples in the clinical setting. The handheld DRS system was employed to determine the skin chromophore concentrations, absorption and scattering properties of 11 patients with psoriasis. The measurement results were compared to the clinical severity of psoriasis as evaluated by dermatologist using PASI (Psoriasis Area and Severity Index) scores. Our statistical analyses indicated that the handheld DRS system could be a useful non-invasive tool for objective evaluation of the severity of psoriasis. It is expected that the handheld system can be used for the objective evaluation and monitoring of various skin diseases such as keloid and psoriasis.
BACKGROUND: Stretch marks are skin scar tissue that appears in the form of purplish linear atrophy, erythematous or hypopigmented which is often caused by excessive stretching of the skin. Increased cortisol levels can cause an increase in collagen degradation which results in disruption of the extracellular matrix in the dermis, resulting in stretch marks. Physical stress can trigger activation of the hypothalamic-pituitary-adrenal axis, which will induce activation of stress hormones, including cortisol in the adrenal cortex. AIM: The objective of the study is to determine the correlation between serum cortisol levels and stretch marks in male at a gymnastics training site. SUBJECTS AND METHODS: Observational analytic study with a cross-sectional approach to 50 stretch marks subjects. RESULTS: Serum cortisol levels of subjects with stretch marks averaged 9.72 g/dL with the lowest level of 4.45 g/dL and the highest level of 49.25 g/dL (p < 0.001). The highest age with stretch marks was 26–30 years 18 (36%) subjects and the lowest age was aged 36–40 years 5 (10%) subjects. The majority of stretch marks are located in the axillary region (30.9%), brachii (23.6%), and abdomen (18.4%). The average cortisol level in subjects with aerobic exercise was 6.52 g/dL, muscle training 11.18 g/dL, mixed aerobic and muscle training 7.5 g/dL. The highest average cortisol levels were at exercise duration of 31–60 min of 12.88 g/dL, 61–90 min of 6.63 g/dL, and 91–120 min of 6.2 g/dL. The highest frequency of exercise in a week was 3–4 times as many as 30 subjects (60%) with an average serum cortisol level of 11.1879 g/dL. CONCLUSION: There is a significant correlation between serum cortisol levels and stretch marks in male at gymnastics training.
Palmoplantar psoriasis (PPP) is a chronic, inflammatory dermatosis of the palms and/or soles with significant morbidity. It is notoriously difficult to treat and unresponsive to traditional topical agents. To compare the effect of oral Methotrexate (MTX) monotherapy vs Methotrexate plus Narrowband UVB (NB‐UVB) in treatment of recalcitrant PPP. This was a comparative clinical trial involving 90 patients of PPP. Eligible patients were randomly assigned to one of the two treatment groups. Patients in Group A received 10 mg oral MTX weekly, and patients in Group B received oral MTX 10 mg weekly and NB‐UVB sessions twice weekly for 12 weeks. There was a statistically significant difference in reduction of m‐PPPASI of patients in MTX plus NB‐UVB at weeks 12. The mean m‐PPPASI at week 12 was 3.66 ± 2.11 in MTX plus NB‐UVB group and 6.51 ± 2.04 in MTX only group (P < 0.001). Marked improvement (m‐PPPASI 75) was achieved in 20 (44.44%) patients in MTX plus NB‐UVB group compared with 6 (13.3%) in MTX monotherapy group (P < 0.001). Combination of MTX and NB‐UVB phototherapy helps to attain a better clinical response (reduction in m‐PPPASI score) than MTX monotherapy in the treatment of recalcitrant PPP.
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Abnormal regions on a face are often indicative of facial dermatological diseases, such as rosacea, eczema, allergy, burn injury, facial rash and acne. Identification and quantitative evaluation of these facial disorders is often subjective and currently done by expert dermatologists. However, with the advances in image processing techniques, it is now possible to consistently identify, classify and objectively quantify facial skin disorders using digital photographs. Furthermore, digital photographs can be used to assess progression of the diseases by applying time-series analysis on infected (abnormal) facial regions of the photograph. In this paper, we propose a novel real-time approach for detection and segmentation of abnormal facial regions. Experimental results showed that the proposed method is efficient for segmentation of abnormal regions, which were caused by facial fever or disease, from digital photographs in terms of accuracy and required processing time.
