====== Plaque Psoriasis ====== ====== Presentation 3: Plaque Psoriasis Powerpoint File ====== {{:psoriasis_slides.pdf|}} ====== Introduction ====== Psoriasis is a chronic, autoimmune disease of the skin and joints (Langley et al., 2005). Robert Willan, the father of modern dermatology, is credited with the first detailed clinical description of psoriasis, and hence, it is also termed as Willan'slepra (Dogra & Mahajan, 2016). Although there are five main types of of psoriasis, plaque psoriasis is the most common type, accounting for 90% of all cases (Mak et al., 2010). Plaque psoriasis is predominantly characterized by abnormal red, silver and scaly skin patches covering the body (Dogra & Mahajan, 2016). While the pathogenesis is unclear, plaque psoriasis is attributed to a T-cell mediated hyper proliferation of keratinocyte (Gudjonsson et al., 2004). The skin patches typically appear on the scalp, back, trunk, elbows, knees, and genital areas but can also affect any other areas of the body. Distribution and severity of plaques on the body is random, and vary greatly from patient to patient from large coverage of the body in lesions to localized plaques no larger than a dime. The stigmatizing visible markings of this condition can have a significant negative impact on the physical, emotional, and, psychosocial wellbeing of affected patients (Langley et al., 2005). {{:pi1.png|}} Figure 1: Plaque psoriasis Image from: http://jamanetwork.com/journals/jama/fullarticle/1104805 Psoriasis is found worldwide but the prevalence varies among different ethnic groups (Dogra & Mahajan, 2016). While men and women are afflicted with equal frequency, plaque psoriasis is more common in adults then children. It also has a strong genetic predisposition but environmental factors such as infections can play an important role in the presentation of disease (Langley et al., 2005). Currently, there is no cure for psoriasis and treatment is largely symptomatic and vary according to the severity of the disease. Earlier treatments have included application of emollients or keratolytic agents to hydrate the skin or shed off the skin (Raut et al., 2013). Later treatments, such as topical agents have been modified to treat the underlying T-cell proliferation. Systemic treatments including methotrexate, cyclosporine, acitretin, as well as light therapy are prominent for severe psoriasis(Raut et al., 2013). A combination of these therapies have provided effective and rapid modalities to suppress the disease and reduce the toxic side effects of treatment.
====== Epidemiology ====== The worldwide prevalence of psoriasis is estimated to be approximately 2–3% (Dogra & Mahajan, 2016). The disease is known to have higher prevalence in the polar regions of the world attributed to differences in sunlight exposure (Dogra & Mahajan, 2016). While psoriasis is found worldwide, the prevalence varies among different ethnic groups. It appears to be low in certain ethnic groups such as the Japanese, and may be absent in aboriginal Australians and Indians from South America (Langley et al., 2005). It is also reported to occur with similar frequency in both males and females. While psoriasis can onset at any age, the disease is less common in children than adults. The prevalence of psoriasis in adults ranged from 0.91 to 8.5 percent, and the prevalence of the disease in children ranged from 0 to 2.1 percent (Parisi et al., 2013). Plaque psoriasis appears to have a biomedical age of onset, occurring either between the ages of 15 and 20 years and or the ages of 50 and 69 years (Parisi et al., 2013).
====== Signs and Symptoms ======
====== Diagnosis ======
====== Etiology ======
====== Pathophysiology ======
====== Prognosis ======
====== Treatment and Management ======
====== Future Studies ======
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