1 / 38

Psoriasis

Psoriasis. Dr Fayyaz Chaudhri Maryport Health Services. The Meeting Today. Learn about psoriasis Treatment options. Acknowledgements. http://www.dermnetnz.org/. Psoriasis. Male=female Late teens or over 50 2% of population Wide spectrum of disease Upto 20% associated arthritis

zia-rodriguez
Download Presentation

Psoriasis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Psoriasis • Dr Fayyaz Chaudhri • Maryport Health Services

  2. The Meeting Today • Learn about psoriasis • Treatment options

  3. Acknowledgements • http://www.dermnetnz.org/

  4. Psoriasis • Male=female • Late teens or over 50 • 2% of population • Wide spectrum of disease • Upto 20% associated arthritis • Familial

  5. March of psoriasis disease progression: IL /TNF skin co-morbidities

  6. Look for associated conditons • Fatty (non alcohol) liver – 47% vs 28% normal pop. • High prevalence alcohol problems – death rate 4-5x higher • Non melanoma skin cancers • Depression and suicide risk, anxiety • Metabolic syndrome – BP sugar , cholesterol • High risk cardiovascular problems • Arthritis – upto 30%, ask specifically, EMS , heel pain ( MXR does not prevent it, biologicals might) • Crohns

  7. Types of Psoriasis • Small plaque • Large plaque • Flexural /genital • Guttate • Palmar-plantar ( pustular) • Scalp psoriasis • Nail psoriasis

  8. Occupation Home circumstances expectations Where is the psoriasis What problems Any specific requests History – patient’s story

  9. Guttate Psoriasis TREATMENT OPTIONS MOISTURISERS Coal Tar Mild topical steroid Streptococcal infection UVB therapy

  10. Scalp Psoriasis • Salicylic acid/coconut oil/ coal tar /sulphur compounds – to lift scale • Steroid scalp applications • Calcipotriol (dovonex) scalp lotions • Xamiol gel – combi steroid/calcipotriol • Tar shampoos • moisterisers

  11. Chronic Plaque Psoriasis • Emollients - moisterisers • Salicylic Acid • Coal Tar (exorex lotion) • Calcipotriol (dovonex) • Dithranol • Topical steroids (betnovate) • Combination = dovobet

  12. Chronic Plaque Psoriasis • Emollients - moisterisers • Salicylic Acid • Coal Tar • Calcipotriol • Dithranol • Topical steroids • Combination steroid/calcipotriol =dovobet

  13. Chronic Plaque Psoriasis • Emollients - moisterisers • Salicylic Acid • Coal Tar • Calcipotriol • Dithranol • Steroids

  14. Flexural psoriasis • In some patients, psoriasis localises to the skin folds and genitals: • Armpits • Groin • Under the breasts • Umbilicus (navel) • Penis • Vulva • Natal cleft (between the buttocks) • Around the anus • Many patients have typical psoriasis elsewhere.

  15. Scalp psoriasis Sebo-psoriasis Sebo-psoriasis is an overlap between psoriasis and seborrhoeic dermatitis

  16. Palmoplantar psoriasis • Psoriasis of the palms and soles • Psoriasis may predominantly affect the palms and soles in various ways: • Typical scaly, red patches similar to psoriasis elsewhere • Generalised thickening and scaling of the palms and soles (keratoderma) • Sheets of tiny yellow-brown pustules (palmoplantar pustulosis).

  17. pitting

  18. Total nail destruction

  19. Subungal hyperkeratosis

  20. onycholysis

  21. Dermatology services • Messy treatments • Oral drugs – methotrexate, biologicals, retinoids • UVB/ UVA • Expertise & support

  22. NICE guidelines on the way • Continuous vs interrupted therapy; have a logical approach to systemic therapies – lower threshold to use systemic Rx nowadays: • Methotrexate – consider Pro collagen 3 every 2m as well as LFTs • Acitretin • Ciclosporin (not for over 50s due to age related renal impairment, best in kids and pregnancy) • Fumaric acid esters – not licensed in UK • Biologicals • Combinations

More Related