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

- MUNRO’S 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 : LEINER’S 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