Nail psoriasis results from psoriatic involvement of the nail bed or nail matrix.Patients with nail psoriasis can develop a wide variety of nail ch. Human leukocyte antigen (HLA) studies have shown that type 1 psoriasis which usually affects the skin is strongly associated with HLA-Cw6 13 and these patients have an earlier onset of disease which is also more extensive and severe, whereas, type 2 psoriasis that predominantly damages the nails and the joints is not associated with HLA Cw6 suggesting a different immunopathology. Longitudinal follow-up of the patients will provide robust information about disease development and response to treatment. Nail changes were also more frequent in patients with late-onset psoriasis (17 late vs early onset 6, p0.001).
Streptococcal infection is strongly associated with the development of guttate psoriasis but this may also apply to chronic plaque psoriasis. Acute episodes of plaque psoriasis may evolve into more severe disease – eg, pustular or erythrodermic psoriasis. Any involvement of nails, high-impact and difficult-to-treat sites (eg, the face, scalp, palms, soles, flexures and genitals). Therapy is usually administered 2-3 times per week, with maintenance treatments every 2-4 weeks until remission. This review reflects basic epidemiological data on Indian psoriasis patients to provide a comprehensive overview of psoriasis in India. Nail involvement is more common in those who have concurrent psoriatic arthritis. Age of onset ranged from 4 days to 14 years, male and female incidence was equal, and plaque type psoriasis was the most common clinical presentation. Kaur et al. reported vitiligo as the most common cutaneous disease (1.7) found to be associated with psoriasis. Psoriatic arthritis – follow up study. In addition to involving the skin, psoriasis frequently involves the nails, and some patients may experience inflammation of the joints (pso-riatic arthritis). In persons with earlier age of onset, psoriasis is more likely to be severe, with involvement of a large area of skin surface. Erythrodermic psoriasis can develop de novo or evolve from typical plaque-type or guttate psoriasis.
Musculoskeletal syndromes that occur in HIV-infected patients include manifestations of drug toxicity, reactive arthritis, Reiter’s syndrome, infectious arthritis, and myositis (Table 1). Nail involvement occurs in most patients who present with inflammatory articular symptoms. Patients with HIV infection and psoriatic arthritis fall into one of two patterns of disease: either the articular disease is sustained and aggressive, progressing to joint erosions, or it is characterized by mild and intermittent joint involvement. The clinical manifestations of Reiter’s syndrome either occur along with or, most commonly, follow the onset of clinically apparent immunodeficiency. PGA of 4-5 was designated as severe psoriasis (SP), and PGA of 1-2 mild psoriasis (MP). This study is the first to examine the relationship between nail/scalp involvement and patient sex in the pediatric population. 15-17) and has been proposed to result from concurrent enthesopathy of the distal interphalangeal joint and nail matrix (18). Nail involvement is more common in those who have concurrent psoriatic arthritis.
Chronic Plaque Psoriasis. Symptoms, Causes And Treatment
In contrast, subjects with SP (35.9) more often reported a history of guttate lesions than did those with MP (21.8) (p.02). Although studies in adults have correlated severity and history of arthritis with scalp and nail involvement, similar investigations have never been conducted in children. This study is the first to examine the relationship between nail and scalp involvement and patient sex in children. 4 Mercy et al: Clinical Manifestations of Pediatric Psoriasis 427 our cohort had guttate psoriasis at onset. Cutaneous lichen planus (CLP) most commonly involves the flexor surfaces of the extremities and presents as small itchy violaceous Papules in middle-aged adults. Based on data pooling of 64 studies, LP patients have 5.58 times the odds of having concurrent HCV infection than the control population (95 CI: 3. Given that joint disease can precede cutaneous involvement in some patients with PsA, a diagnosis of ‘PsA sine psoriasis’ may occur. Psoriasis – Summary Have I got the right topic? Basis for recommendation Scenario: Nail psoriasis. Koebner phenomenon lesions are often linear in shape, as they follow the route of cutaneous injury. Aside from linear skin injury, linear lesions arising from the Koebner phenomenon can also be seen in mosaic skin disorders (eg segmental lichen planus). Skin conditions that manifest Koebner phenomenon are psoriasis, vitiligo and lichen planus. However, there have been reports of possible Koebner phenomenon in many other conditions (table 1). Of these, 40 were diagnosed with PsA concurrently with psoriasis and were excluded from analysis.