Psoriasis can present at any age and has been reported at birth and in older people of advanced age. 7 Patients with early onset, or type I psoriasis, tended to have more relatives affected and more severe disease than patients who have a later onset of disease or type II psoriasis. The various types and presentations of psoriasis are outlined below. The commonest form of psoriasis is plaque psoriasis in which patients may have sharply circumscribed, round-oval, or nummular (coin-sized) plaques (fig 2). Pain (especially in erythrodermic psoriasis and in some cases of traumatized plaques or in the joints affected by psoriatic arthritis). Psoriasis has a large spectrum of clinical features and evolution, so no complete agreement on the classification of the clinical variants exists. Plaque psoriasis is the commonest form (more than 80 of affected patients). Fatigue, myalgia, shortness of breath, fever and chills may also occur.
Very occasionally, it can be the first presentation of psoriasis. Corticosteroid treatment is tricky: subsequent withdrawal may worsen the clinical state but, sometimes, this is the only effective treatment for the acute episode. Trauma – psoriasis may be spread to uninvolved skin by various types of trauma. A number of studies have suggested that people with psoriasis may have an increased risk of cardiovascular disease, lymphoma and non-melanoma skin cancer. Figure 2. Generalized plaque psoriasis. 4.2. Guttate psoriasis. It may range from apparently healthy to minor signs to overt clinical manifestations.
More severe psoriasis may be treated with phototherapy, or may require systemic therapy. Approximately 90 percent of affected patients have plaque psoriasis, characterized by well-defined round or oval plaques that differ in size and often coalesce6 (Figure 1). Psoriatic arthritis is a seronegative inflammatory arthritis with various clinical presentations. Clinical features. Erythrodermic psoriasis may be precipitated by:. Individual cases have been reported to have successful outcomes with biologic agents, including the TNF-alpha inhibitors adalimumab, etanercept and infliximab, and ustekinumab. Other presentations, such as guttate, pustular, erythrodermic, inverse, and nail psoriasis also occur (). Most cases. Estimates of the prevalence of psoriasis have varied across studies. A systematic review of international population-based studies found wide variation in the global prevalence of psoriasis 1. There is no clear gender predilection for psoriasis 1,2. The incidence of psoriasis may be increasing.
Erythrodermic Psoriasis. Psoriasis Treatment And Symptoms
Psoriasis affects 24 of males and females. Theories about the causes of psoriasis need to explain why the skin is red, inflamed and thickened. The scale is typically silvery white, except in skin folds where the plaques often appear shiny and they may have a moist peeling surface. Chronic plaque psoriasis. The type and clinical manifestations of psoriasis in a patient depend on a combination of genetic influences, environmental factors (i. Psoriasis patients are not only more likely to have CV risk factors but severe psoriasis may serve as an independent risk factor for CV mortality. Inverse psoriasis involves intertriginous areas (i.e skin folds of axilla, inguinal, intergluteal and inframammary regions). Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. You may have a single outbreak that goes away on its own, or you may have repeated episodes. Epidemiology, clinical manifestations, and diagnosis of psoriasis. Guttate psoriasis is a type of psoriasis that looks like small salmon-pink drops on the skin. Alternatively, a person who has had plaque psoriasis for a long time may suddenly have an episode of guttate psoriasis. Types of Psoriasis Psoriasis is a chronic disease of the skin that affects approximately 5. Guttate psoriasis refers to a distinctive, acute clinical presentation of an eruption characterized by small, droplike, 1-10 mm in diameter, salmon-pink papules, usually with a fine scale. A variety of laboratory abnormalities can be encountered with psoriasis, particularly. Research & Clinical Trials About Clinical Trials Participating in Clinical Trials Questions to Ask. Other types are guttate, inverse, erythrodermic, and pustular. Guttate psoriasis can also develop in patients who have already had other forms of psoriasis, most often in people treated with widely-applied topical (rub-on) products containing corticosteroids. The patient then takes one or two powerful body-wide drugs for 1 – 2 years and stops. The following safety features should be available in the PUVA chamber:.