CHARACTERIZED BY ERYTHEMA, PAPULES OR

PLAQUES AND SCALING

A. TRUE EPS
1. PSORIASIS
2. P. ROSEA
3. SEBORRHEIC DERMATITIS
4. ERYTHRODERMA
5. PARAPSORIASIS
6. PITYRIASIS RUBRA PILARIS
7. LICHEN PLANUS
8. LICHEN STRIATUS
9. LICHEN NITIDUS
B. EPS - LIKE

1. DERMATOFITOSIS
2. T. VERSIKOLOR
3. DRUG ERUPTION
4. SYPHILIS II
5. LUPUS ERYTHEMATOSUS
6. MORBUS HANSEN
7. MYCOSIS FUNGOIDES
PSORIASIS
* IS A COMMON PAPULO SQUAMOUS DISEASE
* E/ ?
* SHOWING WIDE VARIATION IN SEVERITY & IN
DISTRIBUTION
* CHRONIC
EPIDEMIOLOGY :
- PSORIASIS IS FOUND ALL OVER THE WORLD
- MALES FEMALES
- THE ONSET OF THE DISEASE IS LESS COMMON
IN THE VERY YOUNG & THE ELDERY
ETIOLOGY & PATHOGENESIS
AT THE CELLULAR LEVEL IT IS ACCEPTED
THAT PSORIATIC KERATINOCYTE DIFFERS
FROM THE NORMAL KERATINOCYTE
GENETICALLY IN ITS RESPONSE TO
VARIOUS STIMULI
ENDOGENOUS & EXTERNAL STIMULI
CLINICAL MANIFESTATIONS
- A SHARPLY DEFINED BORDER, A BRIGHT RED
COLOR & A SILVERY - WHITE SCALE DELINEATE
THE LESION OF PSORIASIS
- SITE OF PREDILECTION THE ELBOWS &
KNEES, THE
SCALP & LUMBO
SACRAL SKIN
- SUBTLE DISTORTIONS OF NAILS, MUCOSAL
CHANGES, ISOMORPHIC PHENOMENON
CLINICAL FORMS OF PSORIASIS
- COMMON PLAQUE OR NUMULAR PSORIASIS
- INVERSE OR FLEXURAL PSORIASIS
- GUTTATE PSORIASIS
- FOLLICULAR PSORIASIS
- PALMAR PSORIASIS
- PUSTULAR PSORIASIS
- EXFOLIATIVE PSORIASIS
- PSORIATIC ARTHRITIS
HISTOPATHOLOGY
- ACANTHOSIS WITH ELONGATION OF THE RETE RIDGES
- ELONGATION OF THE DERMAL PAPILLAE
- PARAKERATOSIS
- MUNROS MICROABSCESSES
TREATMENT
- TOPICAL : * SALICYLIC ACID
* TARS
* CORTICOSTEROIDS
* SUN - UV LIGHT THERAPHY
ANTHRALIN GOECKERMAN TECHNIQUE
AND THE INGRAM TECHNIQUE
* PUVA
- SYSTEMIC : * CORTICOSTEROIDS
* ANTIMITOTIC AGENTS
* ETRETINATE
* AROXMATIC RETINOIDS
- DIALYSIS

PROGNOSIS QUO AD VITAM TYPE OF PSORIASIS
QUO AD FUNCTIONAM AD BONAM
QUO AD SANATIONAM DUBIA AD
BONAM
SEBORRHEIC DERMATITIS
CHRONIC DERMATOSIS CHARACTERIZED BY
REDNESS & SCALING
ITS OCCURS IN THE AREAS OF THE SKIN IN WHICH
THE SEBACEOUS GLANDS ARE MOST ACTIVE
FACE, SCALP, IN THE BODY FOLDS, PRESTERNAL
REGION
ETIOLOGY ?
MANY HYPOTHESES HAVE BEEN MADE
AS TO ITS CAUSE
- SEBORRHEA
- PITYROSPORUM OVALE INFECTION
- INFECTION BY CANDIDA OR STAPHYLOCOCCI
- EMOTIONAL RESPONSES TO STRESS OR FATIQUE
- ABNORMAL DIET
EPIDEMIOLOGY
- AGE : * INFANCY
* PUBERTY
* > 50 YEARS
- SEX : MALES
- INCIDENCE : VERY COMMON
- PREDISPOSING FACTOR : OFTEN A GENETIC DIATHESIS
CLINICAL MANIFESTATIONS
INFANCY
* CRADLE CAP
* GLABROUS : FLEXURAL, DIAPER AREA &
TRUNK
* GENERALIZED : LEINERS DISEASE
ADULTS
* SCALP PITYRIASIS SICCA
* FACIAL, FLEXURAL & TRUNCAL
* GENERALIZED ERYTHRODERMA
LABORATORY FINDINGS
HISTOPATHOLOGY
DIFFERENTIAL DIAGNOSIS
- ATOPIC DERMATITIS
- ALLERGIC AND IRRITANT CONTACT
DERMATITIS
- PITYRIASIS ROSEA
- DERMATOPHYTE INFECTION
- CANDIDIASIS
TREATMENT :
* CONSERVATIVE
- SHAMPOO
- EMOLLIENTS & CREAMS
* INTENSIVE
- KETOCONAZOLE CREAM
- TOPICAL STEROIDS
- TAR PREPARATIONS
PROGNOSIS : QUO AD VITAM AD BONAM
QUO AD FUNCTIONAM AD BONAM
QUO AD SANATIONAM DUBIA AD -
BONAM
PITYRIASIS ROSEA
PROBABLY CAUSED BY AN INFECTIOUS AGENT
AGE : 10 - 35 YEARS
DURATION OF LESIONS :
- A HERALD PATCH PRECEDES THE
EXANTHEMATOUS PHASE
- THE EXANTHEMATOUS PHASE DEVELOPS OVER A
PERIOD OF 1 TO 2 WEEKS
PHYSICAL EXAMINATION :
- SKIN SYMPTOMS : PRURITUS ABSENT, MILD OR
SEVERE
- SKIN LESIONS
* HERALD PATCH 2 - 5 CM, BRIGHT RED, SCALE
* FINE SCALING MACULES AND PAPULES WITH
MARGINAL COLLARETTE
CHARACTERISTIC PATTERN OF THE LESIONS
THE LONG AXES OF THE LESIONS FOLLOW
THE LINES OF CLEAVAGE IN A
CHRISTMAS TREE DISTRIBUTION
TRUNK & PROXIMAL OF THE ARMS & LEGS
DIFFERENTIAL DIAGNOSIS
- DRUG ERUPTIONS
- T. CORPORIS
- SECONDARY SYPHILIS
- T. VERSICOLOR
TREATMENT
- TOPICAL : * POWDER
* CREAM ( CORTICO STEROID )
- SYSTEMIK : ANTIHISTAMINES
PROGNOSIS :
QUO AD VITAM AD BONAM
QUO AD FUNCTIONAM AD BONAM
QUO AD SANATIONAM AD BONAM

SPONTANEOUS REMISSION IN 6 - 12 WEEKS
ERYTHRODERMA
REACTION PATTERN OF THE SKIN CHARACTERIZED BY
GENERALIZED, CONFLUENT REDNESS, SCALING &
ASSOCIATED WITH SYSTEMIC SYMPTOMS
AGE ~ ETIOLOGY
ETIOLOGY
- EXTENSION OF PREEXISTING DERMATOLOGIC
DISEASE
PSORIASIS, ATOPIC DERMATITIS, SEBORRHEIC
DERMATITIS
- DRUGS REACTIONS
- SEZARY SYNDROME
- EXTENSION OF SYSTEMIC DISEASE
LUPUS ERYTHEMATOSUS
SKIN LESION :
SKIN IS RED, THICKENED & SCALY UNIVERSALIS
LABORATORY & HISTOPATHOLOGY ~ ETIOLOGY
TREATMENT ~ ETIOLOGY
- THE PATIENT SHOULD BE HOSPITALIZED
- TOPICAL : EMOLLIENTS
- SYSTEMIC : CORTICOSTEROID

PROGNOSIS ~ ETIOLOGY