PSORIASIS
Psoriasis is a papulo-squamous disorder characterised by sharply defined, slightly elevated bright red papules or plaques covered with fine dry silvery scales removal of which reveals punctate bleeding spots from the elongated hyperaemic capillary loops in the dermal papillae (Auspitz sign). No age is exception but first attack usually occurs between the ages of 10 and 30, however, young adults of both sexes are most commonly affected. Genetic predisposition is present with incomplete penetrance and strong association with HLA-B13, HLA-Bw17 and HLA-Cw6. Environmental factors, trauma, sunlight, infections, emotional stress, physical fatigue, an acute infection, climatic changes may precipitate relapses, extension, generalization and recurrences or it may be spontaneous but most patients worsen in winter. Central clearing and peripheral extension give rise to annular lesions while confluence of adjacent plaques can produce extensive sheets. In most cases the disability is cosmetic and aesthetic as irritation is usually absent but it may be severe in nervous individuals. The disease involves extensor surfaces and bony prominence of elbows, knees, hands, lumbo-sacral region, palms, soles, scalp, nails, trunk and genitals but any part of the body may be affected. Lesions are often localized to sites of trauma or irritation (Koebner’s isomorphic phenomenon).
Palmoplanter, Guttate, Pustular, Rupioid, Flexural, Erythrodermic, Intertriginous or Genital, Exfoliative Psoriasis and Psoriasis of scalp, nails and joints are different clinical forms of Psoriasis.
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