By Lionel Fry
Whereas huge advances were made in administration of psoriasis within the final ten years, there's nonetheless no absolute medication, and no basic, secure, and consistently powerful therapy. accordingly, the necessity for an up to date, authoritative, visually attractive, functional relief to prognosis remains to be paramount for powerful therapy of this disorder.
Written by way of Lionel Fry, one of many world's so much distinctive dermatologists, this thoroughly revised moment variation is an entire replace of the the world over acclaimed first variation of An Atlas of Psoriasis. Copiously illustrated in colour, together with new top of the range visible imagery only in the near past on hand, the atlas highlights new cures reminiscent of mild treatment and topical, systemic, and immunomodulatory medications. delivering an authoritative overview of psoriasis, the booklet is an important reference for dermatologists, dermatopathologists, internists, and kin physicians.
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Additional info for An Atlas of Psoriasis, Second Edition (Encyclopedia of Visual Medicine Series)
Dithranol, or following the withdrawal of potent topical steroids. This localized form may simply be an extension of chronic plaque psoriasis but with an increase in the chemotactic factors for neutrophils. At present, it is not known whether there are distinct pathogenic mechanisms in generalized pustular psoriasis, compared to chronic plaque disease, determined by genetic variation. Alternatively, the pustular phase is simply a more acute form of psoriasis with a greater release of chemotactic factors for neutrophils.
LINEAR PSORIASIS This is a rare form of presentation. The psoriatic lesion presents as a straight line on limbs (Figure 81), or may be limited to a dermatome on the trunk. In adults, the etiology of this form of the disease is unknown. In children it has been postulated as being due to an underlying nevus, which may predispose to the psoriatic process in susceptible individuals. PSORIASIS AT SPECIFIC SITES Scalp Figure 80 Confluent involvement in diaper (napkin) area, and papules and plaques on the trunk in diaper ‘psoriasis’ The scalp is one of the commonest sites to develop psoriasis, and there may be no lesions elsewhere.
Occasionally, psoriasis (distinct from localized pustular psoriasis) may only affect the palms and/or soles. The appearance of psoriasis on the palms and soles tends to be different from the lesions elsewhere and this may give rise to diagnostic difficulty. The different clinical presentation is probably due to the different structure of the skin on the palms and soles. On the occasions when guttate psoriasis affects the palms and soles, it presents as hard reddish brown papules (Figure 88). There may or may not be some scale, but, if present, it is fairly adherent, unlike the lesions elsewhere on the trunk and limbs.