Page 54 - LECTURE NOTES

Patients with moderate to severe inflammatory acne may be treated with prescription

of topical or oral medicines, alone or in combination.

Advice needs to be given to the patient

1. Chronicity of the problem
2. Not to squeeze acne lesion

3. washing with warm water but has to avoid irritants

4. Not to use cortisone cream

3.12. Psoriasis

Psoriasis is a chronic inflammatory and proliferative disorder of the skin clinically
manifested as well-circumscribed, erythematous papules and plaques covered with

silvery scales typically located over the extensor surfaces and scalp. While specific
systemic and environmental factors are known to influence the disease, it has

unpredictable course with spontaneous improvement and exacerbations of lesions.

Immune system dysfunction in the background of a genetic predisposition is believed to
be at the core of the disease process.

Epidemiology Psoriasis affects 1-2% the population in all geographic regions. The
Male and female ratio is 1 to 1 and the peak age of onset is in the 20s

Etiology and Pathogenesis

Despite being the subject of intensive research over the years, the precise etiology of
psoriasis still remains unknown. Genetic factors can be implicated on the basis of

population surveys, twin studies (65% concordant in monozygotic twins) and analysis of
pedigrees. The precise mode of inheritance is uncertain, thought to be polygenic.

Provocating factors: A number of factors may provoke onset or aggravation of

psoriasis.

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