Dermatologist Kevin Sharghi describes how patients present with psoriasis and psoriasis arthritis, as well as discusses the latest medical treatment options which range from topical, photo therapy to new biologic therapies.
Psoriasis is a chronic dermatologic disorder characterized by scaly, salmon colored plaques, most commonly on the scalp and extensive surfaces of the body, but can be anywhere it can burn. Sting are itch. The exact cause is not known, but studies have demonstrated an aberrant T cell function and carotenoids site response to be the culprits. It tends to run in families. Normally, it takes about a month for the skin to turn over. In psoriasis, that immune dysfunction drives the skin to turn over within days, leading to those thick, scaly plaques. Plaque type is the most common form of psoriasis, but other variants include inverse gut taped plus Schuler and urethra thermic Eritrea, Germany and push alert can be life threatening and requires immediate attention. Mhm. The diagnosis is clinical, as the physical exam findings of those scaly plaques are characteristic. Occasionally, a biopsy may be taken for osteopathic exam for atypical presentations are for those are not responding to traditional therapy. Psoriatic arthritis can present in numerous ways. Patients will often endorse joint pain and stiffness in the morning or after prolonged rest that improves with activity. The axial skeleton may also be involved. Often we ask our rheumatology colleagues for their expertise. There are guidelines for the diagnosis of psoriatic arthritis, and X rays may be taken to monitor disease progression. Yeah, mhm. We often treat psoriasis based upon the body surface area of involvement, severity and patients desired outcomes. Gentle skincare is essential for all patients with chronic dermatologic disorders. Topical steroids in the mid to high potency strengths are our workhorse of dermatology. They are effective and well tolerated. Topical calcium urine inhibitors, vitamin D, analogue and retinoids may also be utilized. Photo therapy or ultraviolet light therapy is a great option for patients with more extensive disease. It is safe and effective. This is available at Johns Hopkins. Patients are exposed to a specific anti inflammatory wavelength of light 2 to 3 times per week until remission is induced, followed by lower frequency maintenance doses. Newer biologic therapies, commonly called injectables, have been game changers. More research into the path of physiology of psoriasis has revealed sadikin that can be targeted. These medications may sound intimidating by are safe and have incredible results. Oral medications are also available for psoriatic arthritis. We are aggressive as the joint disease can be debilitating and permanent In these instances, we utilize methotrexate or certain biologics that have been approved for the use of this arthritis. Yeah. Mm, yeah.
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