Psoriasis: Causes, Triggers, Treatment, and More Psoriasis t
Psoriasis is a long-lasting autoimmune disease which is characterized by patches Psoriasis t abnormal skin. They may Psoriasis t in severity from small and localized to complete body coverage. There are five main types of psoriasis: It typically presents with red patches with white scales on top. Areas of the body most commonly affected are the back Psoriasis t the forearms, shins, around the navel, and the scalp. Fingernails and toenails are affected in most people at some point in time.
This may include pits in the nails or changes in nail color. Psoriasis is click the following article thought to be a genetic disease which is triggered by environmental factors.
Symptoms often worsen during Psoriasis t and with certain medications such as beta blockers or NSAIDs. The underlying mechanism involves the immune system reacting to skin cells. Diagnosis is typically based Psoriasis t the signs and symptoms. There is no cure for psoriasis. However, various treatments can help control the symptoms. These areas Psoriasis t called plaques and are most commonly found on the elbows, knees, scalp, and back.
It may be accompanied by severe itching, swelling, and pain. It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic glucocorticoids. They include pustular, inverse, napkin, guttate, Psoriasis t, and seborrheic-like forms. Pustular psoriasis appears as raised bumps filled with noninfectious pus pustules. Inverse Psoriasis t also known as flexural psoriasis Psoriasis t as smooth, inflamed patches of skin.
The patches frequently affect skin foldsparticularly around the genitals between Psoriasis t thigh and grointhe armpitsin the skin folds of an overweight abdomen known as panniculusbetween the buttocks in the intergluteal cleft, and under the breasts in the inframammary fold. Heat, trauma, and infection are thought to play a role in the development of this atypical form of psoriasis. Napkin psoriasis is a subtype of psoriasis common in infants characterized by red papules with silver scale in the diaper area that may extend to the torso Psoriasis t limbs.
Guttate psoriasis is characterized by numerous small, scaly, red or pink, droplet-like lesions papules. These numerous spots of psoriasis appear over large areas of the body, primarily the trunk, but also the limbs and scalp. Guttate psoriasis is Psoriasis t triggered by a streptococcal Psoriasis t, typically streptococcal pharyngitis.
Psoriasis in the mouth is very rare,  in contrast to lichen planusanother common papulosquamous disorder that commonly involves both the skin and mouth. When psoriasis involves the oral mucosa the lining of the mouthit may be asymptomatic,  but it may appear as white or grey-yellow plaques. The microscopic appearance of oral Psoriasis t affected by geographic tongue migratory stomatitis is very similar to the appearance of psoriasis.
Seborrheic-like psoriasis is a common form of psoriasis with Psoriasis t aspects of psoriasis and seborrheic dermatitisand may be difficult to distinguish from the latter.
This form of psoriasis typically manifests as red plaques with Psoriasis t scales in areas of higher sebum production such as the scalpforeheadskin folds next to the noseGruppe Medikamenten für Psoriasis surrounding here mouth, skin on the chest above the sternumand in skin folds.
Psoriatic arthritis is a form of chronic inflammatory arthritis that has a highly variable clinical presentation and frequently Psoriasis t in association with skin and nail psoriasis. This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriasis can affect the nails and produces link variety of changes in the appearance of finger and toe nails.
In addition to the appearance and distribution of the rash, specific medical signs may be used by medical practitioners to assist with diagnosis. Around one-third of people with psoriasis report a family history of the disease, and researchers have identified genetic loci associated with the condition. These findings suggest both a genetic susceptibility and an environmental response in developing psoriasis. Psoriasis has a strong hereditary component, and many genes are associated with it, but it is unclear how those genes work together.
Most of the identified genes relate to the immune system, particularly the major histocompatibility complex MHC and T cells. Genetic studies are valuable due to their ability to identify molecular mechanisms and pathways for further study and potential drug targets. Classic genome-wide linkage analysis has identified nine loci on different chromosomes associated with psoriasis.
They are called psoriasis susceptibility 1 through 9 PSORS1 through PSORS9. Within those loci are Psoriasis t on pathways that lead to inflammation. Certain variations mutations of those genes are commonly found in Psoriasis t. Some of these genes express inflammatory signal proteins, which affect cells in the immune system that are also involved in psoriasis.
Some of these genes are also involved in other autoimmune diseases. PSORS1 is located on chromosome 6 in the major histocompatibility complex MHCwhich controls important immune functions. Three genes in the PSORS1 locus have a strong association with psoriasis vulgaris: HLA-C variant HLA-Cw6 which encodes a MHC class I protein; CCHCR1 Psoriasis t, variant WWC, which encodes a coiled protein that is overexpressed in psoriatic epidermis; and CDSNvariant allele 5, which encodes corneodesmosina protein which is expressed in the granular Psoriasis t cornified layers of the epidermis and upregulated in psoriasis.
Two major immune system genes under investigation are interleukin subunit beta IL12B on chromosome 5qwhich expresses interleukinB; and IL23R on chromosome 1p, which expresses the interleukin receptor, and is involved in T cell differentiation.
Interleukin Psoriasis-Symptome der Maul- and IL12B have both been strongly linked with Psoriasis t. A rare mutation in the gene encoding for the CARD14 protein plus an environmental trigger was enough to cause plaque psoriasis the most common form of psoriasis.
Conditions Psoriasis t as worsening the disease include chronic infections, stress, and changes in season and climate. The rate of psoriasis in HIV-positive individuals is comparable to that of HIV-negative individuals, however, psoriasis tends Psoriasis t be more severe in people infected with HIV. Psoriasis has been described as occurring after strep throatand may be worsened by skin or gut colonization with Staphylococcus aureusMalasseziaand Candida albicans.
Psoriasis t psoriasis may occur with beta blockers lithium antimalarial medications non-steroidal anti-inflammatory drugs terbinafinecalcium channel blockerscaptoprilglyburidegranulocyte colony-stimulating factor interleukinsinterferonsPsoriasis t lipid-lowering drugs: Psoriasis is characterized by an abnormally excessive and rapid growth Psoriasis t the epidermal layer of the skin.
Dendritic cells bridge the innate immune system and adaptive immune system. They are increased in psoriatic lesions  and induce the proliferation of T cells and Psoriasis t 1 helper T cells Th1.
A diagnosis of psoriasis is usually based on the appearance of the skin. Skin characteristics typical for psoriasis are scaly, erythematous plaques, papules, or patches of skin that may be painful and itch. If the clinical diagnosis is uncertain, a skin biopsy or scraping may be performed Nagel-Psoriasis als sie zu behandeln rule out other disorders and to confirm the diagnosis.
Skin from a biopsy will show clubbed epidermal projections that interdigitate with dermis on microscopy. Epidermal thickening is another characteristic histologic finding of psoriasis lesions. Psoriasis t their mature counterparts, these superficial cells Psoriasis t their nucleus. Psoriasis is classified as a papulosquamous disorder and is most commonly subdivided into different categories based on histological characteristics.
Each form has a dedicated ICD code. Another classification Psoriasis t considers genetic and demographic factors. Type 1 has a positive family history, starts before the age of 40, and is associated with Psoriasis t human leukocyte antigenHLA-Cw6. Conversely, type 2 does not show a family history, presents after age 40, and is not associated with HLA-Cw6. The classification of psoriasis as an autoimmune disease has sparked considerable debate.
Researchers have proposed differing descriptions of psoriasis and psoriatic arthritis; some authors have classified them as autoimmune diseases    while others have classified them as distinct from autoimmune diseases and referred to them as Psoriasis t inflammatory diseases. There is no consensus about how to classify the severity Psoriasis t psoriasis. The Click at this page score ranges from 0 minimal impairment to 30 maximal impairment and is calculated with each answer being assigned 0—3 points with higher scores indicating greater social or occupational impairment.
The Psoriasis t area severity index Psoriasis t is the most widely used measurement tool for Psoriasis t. PASI assesses Psoriasis t severity of lesions and the area affected and combines these two factors into a single score from 0 no disease to 72 maximal disease.
While no cure is available for psoriasis,  many treatment options exist. Topical agents are typically used for mild disease, phototherapy for moderate disease, read article systemic agents for severe disease. Topical corticosteroid preparations are the Psoriasis t effective agents when used continuously for 8 weeks; Psoriasis t and coal tar were found to be of limited benefit and may be no better than placebo.
Vitamin Psoriasis t analogues such as paricalcitol were found to be significantly superior to placebo. Combination therapy with vitamin D and a corticosteroid was superior to either treatment alone and vitamin D was found to be superior to coal tar for chronic plaque psoriasis.
Moisturizers and emollients such as mineral oilpetroleum jellycalcipotrioland decubal an oil-in-water emollient were found to increase the clearance Psoriasis t psoriatic plaques.
Emollients have been shown to be even more effective at clearing psoriatic plaques when combined with phototherapy. The emollient salicylic acid is structurally similar to para-aminobenzoic acid PABAcommonly found in sunscreen, and is known to interfere with phototherapy in psoriasis. Coconut oilwhen used as an emollient in psoriasis, has been found Psoriasis t decrease plaque clearance with phototherapy.
Ointment and creams containing coal tardithranolcorticosteroids i. The use of the finger tip unit may be helpful in guiding how much topical treatment to use. Vitamin D analogues may be useful with steroids; however, alone have a higher rate of side effects. Another topical therapy used to treat psoriasis is a form of balneotherapywhich involves daily baths in the Dead Sea.
This is usually done for four weeks with the benefit attributed to sun exposure and Psoriasis t UVB light. This is cost-effective and it has been propagated as an effective way to treat psoriasis without medication. Phototherapy in the form of sunlight has long been used Psoriasis t psoriasis. The UVB lamps should have a timer that will turn off the lamp when the time ends.
One of Psoriasis t problems with clinical phototherapy is the difficulty many patients have gaining access to a facility. Indoor tanning resources are almost ubiquitous today and could be considered as a means for patients to get UV exposure when dermatologist provided phototherapy is not available.
However, a concern with the use of commercial tanning is that tanning beds that primarily emit UVA might not effectively treat psoriasis. One study found that plaque psoriasis is responsive to erythemogenic doses of either UVA or UVB, as exposure to either can cause dissipation of psoriatic plaques.
It does require more energy to reach erythemogenic dosing with UVA. UV light therapies all have risks; tanning beds are Psoriasis t exception, particularly in the link between UV Psoriasis t and the increased chance of skin cancer. There are increased risks of melanoma, squamous cell and basal Psoriasis t carcinomas; younger psoriasis patients, particularly those under age 35, are at increased risk from melanoma from UV light treatment.
The World Health Organization WHO listed tanning beds as carcinogens. A review of studies recommends that people who are susceptible to skin cancers exercise caution when using UV light therapy as a treatment. A major mechanism of NBUVB is the induction of DNA damage in the form of pyrimidine dimers.
This type of Psoriasis t is useful in the treatment of psoriasis because the formation of these dimers interferes with the cell cycle and stops it. The interruption of the cell cycle induced by NBUVB opposes the characteristic rapid division of skin cells seen in psoriasis.
The most common short-term side effect of this form of phototherapy is redness of the skin; less common side effects of NBUVB phototherapy are itching and blistering of the treated skin, irritation of the eyes in the form of conjunctival inflammation or inflammation of the corneaor cold sores due to reactivation of the herpes simplex virus in the skin surrounding the lips.
Eye protection is usually this web page during phototherapy treatments. Psoralen and ultraviolet A phototherapy PUVA combines the oral or topical administration of psoralen with exposure to ultraviolet A UVA light. The mechanism of action of PUVA is unknown, but probably Psoriasis t activation of psoralen by UVA light, which inhibits the abnormally rapid production of the cells in psoriatic skin.
PUVA is associated with nauseaheadachefatigueburning, and itching. Long-term treatment is associated with squamous cell carcinoma but not with melanoma. Psoriasis resistant to topical treatment and phototherapy may be treated with Psoriasis t therapies including medications by mouth or injectable treatments. The majority of people experience a recurrence of psoriasis after systemic treatment is discontinued.
Non-biologic systemic treatments frequently used for psoriasis include methotrexateciclosporinhydroxycarbamidefumarates Psoriasis t as dimethyl fumarateand retinoids.
These agents are also regarded as first-line treatments for psoriatic erythroderma. Biologics are Psoriasis t proteins that Psoriasis t the immune process involved in psoriasis. Psoriasis t generalised immunosuppressive drug therapies such as methotrexate, biologics target specific aspects of the immune system contributing to psoriasis.
European guidelines recommend avoiding biologics if a Psoriasis t is planned; anti-TNF therapies such as infliximab are not recommended for use in chronic carriers of the hepatitis B virus or individuals Psoriasis t with HIV. Several monoclonal antibodies target cytokines, the molecules that cells use to send inflammatory signals to each other.
Two drugs that target T cells are efalizumab and alefacept. Efalizumab is a Psoriasis t antibody that specifically targets the CD11a subunit of LFA Individuals with psoriasis may develop neutralizing antibodies against monoclonal antibodies. Neutralization occurs when an antidrug antibody prevents a monoclonal antibody such as infliximab Psoriasis t binding antigen in a laboratory test. When infliximab no longer binds tumor necrosis factor alphait no longer decreases inflammation, and psoriasis may worsen.
Limited evidence suggests removal Psoriasis t the tonsils may benefit people with chronic plaque psoriasis, guttate psoriasis, and palmoplantar pustulosis. Uncontrolled studies have suggested Psoriasis t individuals with just click for source or psoriatic arthritis may benefit from a diet supplemented with fish oil rich in eicosapentaenoic acid EPA and docosahexaenoic acid DHA.
The effect of consumption of caffeine including coffee, black tea, mate, and dark chocolate remains to be determined. There is a higher rate of celiac disease among people with psoriasis.
Most people with psoriasis experience nothing more than mild skin lesions that can be treated effectively with topical therapies. Itching Psoriasis t pain can interfere with basic functions, such as self-care and sleep.
Individuals with psoriasis may feel self-conscious about Psoriasis t appearance and have a poor self-image that stems from fear of public rejection go here psychosexual concerns. Psoriasis has been associated with low self-esteem and depression is more common among those with the condition. Clinical research has indicated individuals often experience a diminished Psoriasis t of life.
Several conditions are associated Psoriasis t psoriasis. These occur more frequently in older people. Nearly half of individuals with psoriasis over the age of 65 have at least Psoriasis t comorbidities, and two-thirds have at least two comorbidities.
Psoriasis has been associated with obesity  and several other cardiovascular and metabolic disturbances. Cardiovascular disease risk appeared to be correlated with the severity of psoriasis and its duration. There is no strong evidence to suggest that psoriasis is associated with an increased risk of death from cardiovascular events.
Methotrexate may provide a degree of protection for the heart. The odds of having hypertension are 1. A similar association was noted in people who have psoriatic arthritis—the odds of having hypertension were found to be 2.
The link between psoriasis and hypertension is not currently understood. Mechanisms hypothesized to be involved in this relationship include the following: Approximately one third of people with psoriasis report being diagnosed before age Psoriasis affects about 6.
Scholars believe psoriasis to have been included among the various skin conditions called tzaraath translated as leprosy in the Hebrew Biblea condition imposed as a punishment for slander. The patient was deemed "impure" see tumah and Psoriasis t during their afflicted phase and is ultimately treated by the kohen.
They used the term psora to describe itchy skin conditions. Leprosythey said, is distinguished by the regular, circular form of patches, while psoriasis is always irregular. Willan identified two categories: Psoriasis is thought to have first been described in Ancient Rome by Cornelius Celsus. The disease was European gemeinsame Behandlung von Psoriasis characterized classified by English physician Thomas Willan.
The British dermatologist Thomas Bateman described a possible link between psoriasis and arthritic symptoms in The history of psoriasis is littered with treatments of dubious effectiveness and high toxicity. The International Federation of Psoriasis Psoriasis t IFPA is the global umbrella organization for Psoriasis t and regional psoriasis patient associations and also gathers the leading experts in psoriasis and psoriatic arthritis research for scientific conferences every three check this out. Psoriasis t organizations the National Psoriasis Foundation in the United States, the Psoriasis Association in the Psoriasis t Kingdom and Psoriasis Australia offer advocacy Psoriasis t education about psoriasis in their respective countries.
Pharmacy costs Psoriasis t the main source of direct expense, with biologic therapy the most prevalent. Psoriasis t costs increase significantly when co-morbid conditions such as heart disease, hypertension, diabetes, lung disease and psychiatric disorders are factored in. The role of insulin resistance in the pathogenesis of psoriasis is currently under investigation.
Preliminary research has suggested that antioxidants such as polyphenols may have beneficial effects on the inflammation characteristic of psoriasis. From Wikipedia, the free encyclopedia. List of human leukocyte antigen alleles associated with cutaneous conditions. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics". J Am Acad Dermatol.
Retrieved 22 April National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved 1 July Identification and Management of Psoriasis and Associated ComorbidiTy IMPACT project team. Drug Des Visit web page Ther. Retrieved 16 March Clinical Dermatology 10th ed. From the Medical Board of the National Psoriasis Foundation". Am J Clin Dermatol. Psoriasis t, Michael Glick, Jonathan A. N Engl J Med. Retrieved 8 October The American Journal of Human Genetics.
J Eur Acad Dermatol Venereol. J Int AIDS Soc. A Review Psoriasis t T-cell Subsets and Cytokine Profiles". J Cutan Med Surg. Expert Rev Gastroenterol Hepatol. Clinical dermatology 4th ed. Cytokine Growth Factor Rev. Br J Community Nurs.
Psoriasis t Disease, Psoriasis t Response and Cytokines. Clin Rev Allerg Immunol. The International League of Dermatological Societies. Archived from the original on J Am Board Fam Med. Clin Cosmet Investig Dermatol. Br J Clin Dermatol. Arthritis Psoriasis t Res Hoboken. Cochrane Database Syst Rev.
Guidelines of care for the management and treatment of psoriasis with topical therapies". The Cochrane database of systematic reviews. International Journal of Dermatology. Indian J Dermatol Venereol Leprol.
Psoriasis American Academy of Dermatology". A Review of Phase III Trials. The Point of View of the Nutritionist. Int J Environ Res Public Health Review. Clin Cosmet Investig Dermatol Review. Nat Rev Gastroenterol Hepatol Review. Health Qual Life Outcomes. Clinical dermatology a color guide to diagnosis and therapy 5th ed. Am J Med Sci. Ir J Med Sci Psoriatic and Reactive Arthritis: A Psoriasis t to Rheumatology 1st ed.
The American Journal of Managed Care. L40 ICD - 9-CM: Diseases of the skin and appendages by morphology. Freckles lentigo melasma nevus Psoriasis t. Aphthous stomatitis oral candidiasis lichen planus leukoplakia pemphigus vulgaris mucous membrane pemphigoid cicatricial Psoriasis t herpesvirus coxsackievirus syphilis systemic histoplasmosis squamous-cell carcinoma.
Papulosquamous disorders L40—L45— Guttate psoriasis Psoriatic arthritis Psoriatic erythroderma Drug-induced psoriasis Inverse psoriasis Napkin psoriasis Seborrheic-like psoriasis. Pityriasis lichenoides Pityriasis lichenoides et varioliformis acutaPityriasis lichenoides chronica Lymphomatoid papulosis Small plaque parapsoriasis Digitate dermatosisXanthoerythrodermia perstans Large plaque parapsoriasis Retiform parapsoriasis.
Pityriasis rosea Pityriasis rubra pilaris Pityriasis rotunda Pityriasis amiantacea. Hepatitis-associated lichen planus Lichen planus pemphigoides. Lichen nitidus Lichen striatus Lichen ruber moniliformis Gianotti—Crosti syndrome Erythema dyschromicum perstans Idiopathic eruptive macular pigmentation Keratosis lichenoides chronica Kraurosis vulvae Lichen sclerosus Lichenoid dermatitis Lichenoid reaction of graft-versus-host disease.
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Red Blanchable Erythema Generalized drug eruptions viral exanthems toxic erythema systemic lupus erythematosus. Lichen planus configuration Annular Linear morphology Hypertrophic Atrophic Bullous Ulcerative Actinic Pigmented site Mucosal Nails Peno-ginival Vulvovaginal overlap synromes with lichen sclerosus with lupus erythematosis other:
Their efficacy attracted attention to the activated T cells that are a major component of the inflammatory infiltrate Psoriasis in Exazerbation psoriatic lesions.
Further research determined that T cells from patients with psoriasis could transmit disease in animal models. These findings laid the groundwork for characterizing the pathogenesis of psoriasis Psoriasis t immune mediated with skin-directed T cells playing a central role. Once these pathogenic T cells have Psoriasis Kräutermedikamente the skin, they become activated and release cytokines and chemokines to attract Psoriasis t immune cells to perpetuate the inflammatory cascade.
As the role of the T cell Psoriasis Zinksalbe Anwendung psoriasis has evolved and understanding of immunopathology has increased, a multitude of biologic targets have been revealed.
Newer strategies for the treatment of psoriasis have therefore focused on modifying T cells in this disease through direct elimination Psoriasis t activated T cells, inhibition Psoriasis t T-cell activation, or inhibition of cytokine secretion or activity. The Psoriasis t by which these new biologic agents act Psoriasis t psoriasis will affect their profile of efficacy and Calciumgluconat Bewertungen für. Important selection criteria for optimal antipsoriatic therapies include long-term safety and tolerability, ability to produce long-lasting remissions, and convenient dosing regimens.
National Center for Biotechnology InformationU. National Library of Medicine Rockville PikeBethesda MDUSA. Homology BLAST Basic Local Alignment Search Tool BLAST Psoriasis t BLAST Link BLink Conserved Domain Visit web page CDD Conserved Domain Search Service CD Search Genome ProtMap HomoloGene Protein Clusters All Homology Resources Proteins BioSystems BLAST Psoriasis t Local Alignment Search Tool BLAST Stand-alone BLAST Link BLink Conserved Domain Database CDD Conserved Domain Search Service CD Search E-Utilities ProSplign Protein Clusters Protein Database Reference Sequence RefSeq All Proteins Resources Sequence Analysis BLAST Basic Local Alignment Search Tool BLAST Stand-alone BLAST Link BLink Conserved Domain Please click for source Service CD Search Genome ProtMap Genome Workbench Influenza Virus Primer-BLAST ProSplign Splign All Sequence Analysis Resources Taxonomy Taxonomy Taxonomy Browser Taxonomy Common Tree All Taxonomy Psoriasis t Variation Database of Genomic Structural Variation dbVar Database of Genotypes and Phenotypes dbGaP Database of Single Nucleotide Polymorphisms dbSNP SNP Submission Tool All Variation Resources PubMed US National Library of Medicine National Institutes of Health.
Search database All Databases Assembly Biocollections BioProject BioSample BioSystems Books ClinVar Clone Conserved Domains dbGaP dbVar Psoriasis t Gene Genome GEO DataSets GEO Profiles GSS GTR HomoloGene MedGen MeSH NCBI Web Site NLM Catalog Nucleotide OMIM PMC PopSet Probe Protein Protein Clusters PubChem BioAssay PubChem Compound PubChem Substance PubMed PubMed Health SNP Sparcle SRA Structure Taxonomy ToolKit ToolKitAll ToolKitBook ToolKitBookgh UniGene Search term.
Abstract Format Summary Summary text Abstract Abstract text MEDLINE XML PMID List. Choose Destination File Clipboard Collections E-mail Order My Bibliography Citation manager Format Summary text Abstract text MEDLINE XML PMID List CSV Create File. Add Psoriasis t My Bibliography. Generate a file for use with external citation management software.
See comment in PubMed Psoriasis t below J Eur Acad Dermatol Venereol. Author information 1 Department Psoriasis t Dermatology, Ludwig-Maximilians University, FrauenlobstrausseD Munich, Germany. Abstract Evidence for a key role of T cells in the pathogenesis of psoriasis has come from both experimental Psoriasis Bewertungen losterin clinical data. LinkOut - more resources Full Text Sources Wiley Ovid Technologies, Inc.
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