Advertisement

Psoriasis

  • Lloyd J. CleaverEmail author
  • Nathan Cleaver
  • Katherine Johnson
Chapter

Abstract

Psoriasis is a complex autoimmune-mediated disease typically characterized by erythematous papules and plaques with a silver scale. These lesions usually occur on the elbows, knees, scalp, legs, and sacrum, although other forms exist. Psoriasis is a disease whose mechanism is not fully understood, but results in an increased epithelium production by keratinocytes due to decreased cell cycle of 36 h as compared to the normal proliferative time of 311 h. Psoriasis follows an irregular course marked with exacerbations and remissions of unknown onset and duration. This condition ranges from a life-threatening erythrodermic form to a mild well-localized form. Topical steroids remain the primary therapeutic treatment in psoriasis, although systemic agents are available if necessary according to the severity. In general, treatment plans need to be individualized to meet the physician and the patient’s long-term goals.

Keywords

Silver micaceous scale Auspitz’s sign Psoriatic arthritis Epidermal hyperplasia with parakeratosis Koebner phenomenon 

References

  1. 1.
    Neimann, AL, Porter, SB. and Gelfand, JM. The epidemiology of psoriasis. 2006, Expert Rev Dermatol, 1(1):63–75.CrossRefGoogle Scholar
  2. 2.
    Paller, A. and Anthony, M. Papulosquamous and Related Disorders. Hurwitz Clinical Pediatric Dermatology. 3rd edn. Philadelphia, PA: Elsevier Saunders; 2006:85–94.Google Scholar
  3. 3.
    Nestle, F, Kaplan, D. and Barker, J. Psoriasis. 2009, N Engl J Med, 361:496–509.PubMedCrossRefGoogle Scholar
  4. 4.
    Blauvelt, A. Pathophysiology of psoriasis: recent advances on IL-23 and Th17 cytokines. 2007, Curr Rheumatol Rep, 9:461–467.PubMedCrossRefGoogle Scholar
  5. 5.
    Korn, T. IL-17 and Th17 Cells. 2009, Annu Rev Immunol, 27:485–517.PubMedCrossRefGoogle Scholar
  6. 6.
    Tzu, J. and Kerdel, F. From conventional to cutting edge: the new era of biologics in treatment of psoriasis. 2008, Dermat Ther, 21:131–141.PubMedCrossRefGoogle Scholar
  7. 7.
    Bowcock, AM. and Krueger, JG. Getting under the skin: the immunogenetics of psoriasis. 2005, Nat Rev Immunol, 5:699–711.PubMedCrossRefGoogle Scholar
  8. 8.
    Cargill, M. et al. A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. 2007, Am J Hum Genet, 80:273–290.PubMedCrossRefGoogle Scholar
  9. 9.
    Van de Kerkhof, PCM. Clinical Features. Textbook of Psoriasis. Oxford, UK: Blackwell Science Ltd.; 2003:3–29.Google Scholar
  10. 10.
    VanVoorhees, A. Psoriasis and Psoriatic Arthritis Pocket Guide. www.psoriasis.org. [Online].
  11. 11.
    Sege-Peterson, K. and Winchester, R. Psoriatic Arthritis. Fitzpatrick’s Dermatology in General Medicine. Vol 2, 5th edn. New York, NY: McGraw-Hill Inc; 1999:522–533.Google Scholar
  12. 12.
    Jiaravuthisan, MM, Sasseville, D. and Vender, RB. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. 2007, J Am Acad Dermatol, 57:1.PubMedCrossRefGoogle Scholar
  13. 13.
    Gisondi, P. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. 2007, Br J Dermatol, 157:68–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Ludwig, RJ. Psoriasis: a possible risk factor for development of coronary artery calcification. 2007, Br J Dermatol, 156:271–276.PubMedCrossRefGoogle Scholar
  15. 15.
    Gelfand, JM. Risk of myocardial infarction in patients with psoriasis. 2006, JAMA, 296:1735–1741.PubMedCrossRefGoogle Scholar
  16. 16.
    Gladman, DD, Anhorn, KA, Schachter, RK. and Mervart, H. HLA antigens in psoriatic arthritis. 1986, J Rheumatol, 13:586.PubMedGoogle Scholar
  17. 17.
    Fitzgerald, O. Firestein: Kelley’s Textbook of Rheumatology: Psoriatic Arthritis. [ed.] 8th edn. s.l., Saunders Elsevier; 2008.Google Scholar
  18. 18.
    Wu, I. and Schwartz, R. Reiter’s syndrome: the classic triad and more. 2003, J Am Acad Dermatol, 59(1):113–121.CrossRefGoogle Scholar
  19. 19.
    Papp, KA, Guenther, L, Boyden, B. and Larsen, FG. Early onset of action and efficacy of a combination of calcipotriene and betamethasone dipropionate in the treatment of psoriasis. 2003, J Am Acad Dermatol, 48:48–54.PubMedCrossRefGoogle Scholar
  20. 20.
    Atzeni, F. and Sarzi-Puttini, P. Autoantibody production in patients treated with anti-TNF. 2008, Expert Rev Clin Immunol, 4:275–280.PubMedCrossRefGoogle Scholar
  21. 21.
    Carey, W. Relapse, rebound, and psorasis adverse events:an advisory group report. 2006, J Am Acad Dermatol, 54(4 Suppl 1):S171–S181.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lloyd J. Cleaver
    • 1
    Email author
  • Nathan Cleaver
  • Katherine Johnson
  1. 1.Department of Dermatology, Northeast Regional Medical CenterA.T. Still UniversityKirksvilleUSA

Personalised recommendations