1. psoriasis Definition: is a chronic, sometimes acute, non- contagious common condition of the skin Definition: is a chronic, sometimes acute, non- contagious common condition of the skin scaly disease of the skin, characterized by well- defined, pink or dull red scaly disease of the skin, characterized by well- defined, pink or dull red lesions covered with silvery scales. The edge of the lesion is sharply delineated, and gentle scraping of the lesion will produce mica- like scales. lesions covered with silvery scales. The edge of the lesion is sharply delineated, and gentle scraping of the lesion will produce mica- like scales.

2. Etiology of the disease There is a genetic predisposition to psoriasis in one- fourth of psoriatic patients. type of autoimmune) There is a genetic predisposition to psoriasis in one- fourth of psoriatic patients. type of autoimmune) It mostly develops between 10 and50 years old. It mostly develops between 10 and50 years old. It’s mainly located on scalp, folds of the elbows and knees, and the genito anal region. It’s mainly located on scalp, folds of the elbows and knees, and the genito anal region. They mostly develop at the side of vaccination., scratch marks, surgical incisions, or in skin test sites, and may be precipitated by shock and noise. They mostly develop at the side of vaccination., scratch marks, surgical incisions, or in skin test sites, and may be precipitated by shock and noise. Normally, the time between manufacturing and shedding skin cells is about28-35 days. In psoriasis, the process is approximately7 times faster, but the rate at which old cell slough off is unchanged. this causes cells to build up on the skins surface, forming thick patches, or placques,of red lesion covered with flaky, silvery scales Normally, the time between manufacturing and shedding skin cells is about28-35 days. In psoriasis, the process is approximately7 times faster, but the rate at which old cell slough off is unchanged. this causes cells to build up on the skins surface, forming thick patches, or placques,of red lesion covered with flaky, silvery scales

3. Continue Normal epidermal turnover is 25 to 30 days; in psoriasis plaque skin, it is 3 to 4 day or less. Normal epidermal turnover is 25 to 30 days; in psoriasis plaque skin, it is 3 to 4 day or less. Duration of psoriasis; is variable, lesion may last a life time or it could disappear quickly. The course of the disease is marketed by spontaneous exacerbation and remission. Duration of psoriasis; is variable, lesion may last a life time or it could disappear quickly. The course of the disease is marketed by spontaneous exacerbation and remission.. It has a tendency to become chronic.. It has a tendency to become chronic. Hot weather and sunlight improve the condition,and cold weather causes a considerable worsening Hot weather and sunlight improve the condition,and cold weather causes a considerable worsening

4. Types : Types : Acute guttata psoriasis: attack for about 17% of psoriatic patients. It is most common in children, and is characterized by many small lesions more or less distributed over the body( it may follow streptococcal tonsillitis. Acute guttata psoriasis: attack for about 17% of psoriatic patients. It is most common in children, and is characterized by many small lesions more or less distributed over the body( it may follow streptococcal tonsillitis. Pustular psoriasis: is localized in the palm and soles. Defined as raised bumps on the skin that are filled with pus (pustules ),skin under and around these bumps is red. Pustular psoriasis: is localized in the palm and soles. Defined as raised bumps on the skin that are filled with pus (pustules ),skin under and around these bumps is red. Psoriasis plaque Psoriasis plaque

5. Potent agents should not be used until they are deemed necessary. A simple case of psoriasis may become worse and may lead to general exfoliative dermatitis, in which a general erythema scale, covering the entire body develops. Potent agents should not be used until they are deemed necessary. A simple case of psoriasis may become worse and may lead to general exfoliative dermatitis, in which a general erythema scale, covering the entire body develops. Acute cases with severely erythematous, local therapy should be soothing and non- irritating. Acute cases with severely erythematous, local therapy should be soothing and non- irritating. A blend of,non-medicated cream should be used; as the acute process subside and the usual thick- scaled plaques appear, then more potent medication can be used A blend of,non-medicated cream should be used; as the acute process subside and the usual thick- scaled plaques appear, then more potent medication can be used treatment

6. Plaque psoriasis An occlusive bandage be applied prior application of medicinal agent penetration of drug through thick plaque is difficult unless the area is abraded or occluded An occlusive bandage be applied prior application of medicinal agent penetration of drug through thick plaque is difficult unless the area is abraded or occluded The plaque in psoriasis should be removed prior application of medical agents to allow penetration of the substances The plaque in psoriasis should be removed prior application of medical agents to allow penetration of the substances The use of cytostatic agents are sometimes very effective The use of cytostatic agents are sometimes very effective Topically applied corticosteroids and systematically administered methotexateare prescription drugs Topically applied corticosteroids and systematically administered methotexateare prescription drugs

7. Ingredients in OTC prducts keratolytics: salicylic acid 2 to 10 % keratolytics: salicylic acid 2 to 10 % tar products: combination of tar and keratolytics ( tar products enhance the beneficial effect of sunlight) tar products: combination of tar and keratolytics ( tar products enhance the beneficial effect of sunlight) antihistaminic: to alleviate pruritus, and reduce emotional factors. antihistaminic: to alleviate pruritus, and reduce emotional factors. Tretinoin Tretinoin Prescription drugs : systemically administered methotrexate Prescription drugs : systemically administered methotrexate

8. Scalp psoriasis vs. seborrheic dermatitis: What's the difference? Scalp psoriasis vs. seborrheic dermatitis: What's the difference? Q.How does a doctor tell the difference between scalp psoriasis and seborrheic dermatitis of the scalp? Q.How does a doctor tell the difference between scalp psoriasis and seborrheic dermatitis of the scalp?

9. continue Scalp psoriasis and seborrheic dermatitis of the scalp can be Scalp psoriasis and seborrheic dermatitis of the scalp can be difficult to differentiate. difficult to differentiate. Both are common conditions that affect the scalp. Both are common conditions that affect the scalp.. In addition, they share similar symptoms, such as itchy, red, scaly skin. Fortunately, they also share some similar treatments, such as medicated shampoos. Fortunately, they also share some similar treatments, such as medicated shampoos. However, scalp psoriasis tends to be more resistant than does seborrheic dermatitis to these treatments, However, scalp psoriasis tends to be more resistant than does seborrheic dermatitis to these treatments,

10. The scales of psoriasis are thicker and somewhat drier in appearance than are the scales of seborrheic dermatitis. In addition, psoriasis usually affects more than one area of the body. So if you have scalp psoriasis, you may also have mild psoriasis on your elbows, knees, buttocks or fingers. The scales of psoriasis are thicker and somewhat drier in appearance than are the scales of seborrheic dermatitis. In addition, psoriasis usually affects more than one area of the body. So if you have scalp psoriasis, you may also have mild psoriasis on your elbows, knees, buttocks or fingers.

11. There is no single test to confirm a diagnosis of psoriasis or seborrheic dermatitis. A diagnosis is usually made with a visual examination of the affected skin. In rare cases, a skin biopsy may be needed to differentiate between the two disorders. There is no single test to confirm a diagnosis of psoriasis or seborrheic dermatitis. A diagnosis is usually made with a visual examination of the affected skin. In rare cases, a skin biopsy may be needed to differentiate between the two disorders.

12. Scalp psoriasis Signs and symptoms Scalp psoriasis Signs and symptoms Red patches of skin covered with silvery scales Red patches of skin covered with silvery scales Dry, cracked skin that may bleed Dry, cracked skin that may bleed Itching, burning or soreness Itching, burning or soreness Treatment Over-the-counter medicated shampoos, such as those containing ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid Treatment Over-the-counter medicated shampoos, such as those containing ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid Topical solutions, creams or ointments, such as tar products, corticosteroids or vitamin D analogues Topical solutions, creams or ointments, such as tar products, corticosteroids or vitamin D analogues Light therapy Light therapy

13. Seborrheic dermatitis of the scalp Patchy scaling or thick crust on the scalp Seborrheic dermatitis of the scalp Patchy scaling or thick crust on the scalp Yellow or white scales that may attach to the hair shaft Yellow or white scales that may attach to the hair shaft Red, greasy skin covered with flaky white or yellow scales Red, greasy skin covered with flaky white or yellow scales Small, reddish-brown bumps Small, reddish-brown bumps Itching or soreness Itching or soreness Skin flakes o Skin flakes o

14. Treatment Treatment Over-the-counter medicated shampoos, such as those containing ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid Over-the-counter medicated shampoos, such as those containing ketoconazole, tar, pyrithione zinc, selenium sulfide or salicylic acid Topical solutions or creams such as hydrocortisone cream Topical solutions or creams such as hydrocortisone cream

15. There is no single test to confirm a diagnosis of psoriasis or seborrheic dermatitis. A diagnosis is usually made with a visual examination of the affected skin. In rare cases, a skin biopsy may be needed to differentiate between the two disorders There is no single test to confirm a diagnosis of psoriasis or seborrheic dermatitis. A diagnosis is usually made with a visual examination of the affected skin. In rare cases, a skin biopsy may be needed to differentiate between the two disorders Summary. Summary. Treatment of psoriasis, after proper giagnosis should be initiated in a conservative manner. Treatment of psoriasis, after proper giagnosis should be initiated in a conservative manner. Potent agents reserved when the condition does not respond. Potent agents reserved when the condition does not respond.

16. Thank you for your attention