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Care trateaza unghiile psoriazis
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Este foarte importanta diagnosticarea corecta a bolii si administrarea tratamentului specific; netratata, orice afectiune de piele se agraveaza si afecteaza nu numai sanatatea fizica ci si echilibrul emotional, conducand la aparitia depresiei, anxietatii si la scaderea stimei de sine. Pielea este un organ complex compus din trei straturi: In majoritatea partilor corpului epidermul masoara aproximativ 0,1 mm grosime, dar la nivelul palmelor si al talpilor poate avea 1 mm grosime sau chiar mai mult.
Principala celula a pielii, care formeaza epidermul se numeste keratinocit, deoarece produce o proteina dura, numita keratina. Contine numeroase tesuturi specializate de suport precum si vase sangvine, nervi, radacini ale firului de par si glande sudoripare.
Dermul este format din alte tipuri de proteine, in special colagen si elastina, care ii ofera rezistenta si flexibilitate. Majoritatea bolilor de piele sunt diagnosticate printr-o examinare atenta a pielii la care se adauga informatii legate de istoricul medical al bolnavului.
Unele afectiuni cutanate sunt mai dificil care trateaza unghiile psoriazis diagnosticat intrucat se asemana cu alte care trateaza unghiile psoriazis de piele, si nu numai. De exemplu, rozaceea necesita investigatii suplimentare si examen clinic efectuat de un dermatolog pentru a nu fi confundata cu acneea prezenta la adolescenti.
Pentru stabilirea clara click the following article diagnosticului pot fi necesare biopsia cutanata sau cultura de tesut, efectuate in scopul diferentierii bolilor de piele.
Afectiunile de piele au o multitudine de cauze posibile, care sunt influentate de tipul bolii si premisele acesteia. Care trateaza unghiile psoriazis genetica, hormonii, sistemul imunitar slabit, stresul, influenta mediului, dieta sunt cativa dintre factorii care pot declansa boli de piele. Din aceasta cauza se impune necesitatea unui diagnostic corect prin identificarea cauzelor declansatoare si administrarea tratamentului specific.
ECZEMA Termenul include un grup de afectiuni caracterizate prin roseata, mancarime, iritatie si uneori mici chisturi. Exista mai multe forme de eczema. Dermatita atopica este una dintre cele mai frecvente si mai severe forme.
Cauzele aceste care trateaza unghiile psoriazis nu sunt cunoscute cu exactitate, dar se presupune ca este un mod al sistemului imunitar de a reactiona la mediul inconjurator. In unele forme de eczema pot fi implicate si alergiile. Eczema nu este contagioasa, cu toate ca majoritatea pacientilor detin un istoric medical personal si familial care trateaza unghiile psoriazis bolii. Acesta este motivul pentru care cercetatorii considera ca se mosteneste si se transmite genetic.
Aceasta afectiune este destul de comuna, 1 din 10 persoane sufera de eczema la un anumit moment dat. Persoanele cu eczeme pot suferi de astm si de alte alergii click to see more ar fi, febra fanului.
Care trateaza unghiile psoriazis factori care trateaza unghiile psoriazis sunt: ACNEEA Acneea vulgara este o boala de piele care apare din cauza hiperactivitatii glandelor sebacee. Cand canalul excretor al glandelor sebacee se infunda, celule moarte blocheaza porii si apar punctele negre, iar atunci cand germenii intra in pori, apare puroiul, inflamatia si tumefactia. Aceasta afectiunea apare frecvent in randul adolescentilor si adultilor tineri.
De obicei dispare spontan in jurul varstei de care trateaza unghiile psoriazis de ani. Cu toate acestea, unii adulti care a trecut de varsta de 20 sau chiar 30 de ani pot manifesta acnee. Majoritatea femeilor se confrunta cu afectiunea inainte de debutul ciclului menstrual sau in timpul sarcinii, cand au loc dereglari hormonale. Acneea dispare o data cu incetarea cauzei care a declasat-o.
Partile corpului cel mai des afectate de acnee sunt: Netrata acneea poate provoca cicatrici si poate conduce la manifestari psihice, care includ: Acestea pot fi localizate pe scalp, fata, partea inferioare a spatelui, coate, genunchi, care trateaza unghiile psoriazis, unchii, talpi, interiorul gurii sau chiar pe organele genitale. Manifestarile includ prurit si chiar durere. Afectiunea este cronica si poate afecta calitatea vietii unei persoane, coducand la depresie, stres si anxietate.
Psoriazisul afecteaza atat barbatii cat si femeile, in mod egal, dar cel mai frecvent este afectata rasa caucaziana. Pana in prezent nu a fost descoperit un tratament definitiv al acestei boli, motiv pentru care tratamentele prescrise astazi nu fac decat sa imbunatateasca calitatea care trateaza unghiile psoriazis pacientului si sa amelioreze simptomele. Simptomele caracteristice psoriazisului sunt prezenta placilor cutanate hipercheratozice, leziuni cutanate reliefate lucioase si alergic la soare psoriazis cu localizare predominant la nivelul coatelor si genunchilor.
Exista mai multe tipuri de psoriazis, astfel ca simptomele variaza ca si severitate si complicatii de la un caz la altul. Simptomele cel mai frecvent intalnite in psoriazis sunt urmatoarele: Placile cutanate pot avea diferite localizari, dar cel mai frecvent sunt regasite la nivelul coatelor, genunchilor, scalpului, mainilor, picioarelor si regiunii sacrale care trateaza unghiile psoriazis. Psoriazisul este o boala cronica, cu recidive si acutizari episoade de agravare a bolii care se repeta la un anumit interval de timp si a carei evolutie poate fi imprevizibla.
Simptomele bolii pot aparea brusc si tot care trateaza unghiile psoriazis se pot amelioara see more disparea remisiune. Acest ciclu de acutizari urmate de remisiuni continua pe tot parcursul vietii.
Rar, psoriazisul poate disparea fara efectuarea vreunui tratament. Formele moderat-severe si severe de psoriazis trebuie tratate corespunzator pentru a ameliora simptomele si a evita hondroprotektory psoriazică. Exista mai multi factori care pot agrava boala si pot determina recidive.
Severitatea bolii este indicata de numarul leziunilor si caracteristicile acestora roseata, grosime, care trateaza unghiile psoriazisprecum si de suprafata corporala afectata de care trateaza unghiile psoriazis cutanate hipercheratozice.
Formele usoare de boala, sunt caracterizate prin leziuni cutanate go here localizate doar la nivelul coatelor si genunchilor. Formele moderate de psoriazis prezinta urmatoarele simptome: Formele severe de psoriazis, prezinta urmatoarele simptome: Formele severe de artrita psoriazica pot cauza chiar si distructie osoasa.
Psoriazisul poate persista pentru o perioada mai lunga de timp fara agravarea sau ameliorarea simptomelor. Boala poate cauza stres psihic si anxietate, precum si aparititia unor complexe de ordin cosmetic. Unele studii au evidentiat faptul ca unii pacienti cu psoriazis prezinta o alterare functionala si psihica asemanatoare pacientilor care sufera de alte boli grave precum cancerul, artrita cronica, depresia sau bolile cardiace.
Uneori, este necesar ca tratamentul medicamentos al psoriazisului sa asocieze si psihoterapie. Se stie ca in prezent nu care trateaza unghiile psoriazis nici un tratament curativ care vindeca boala pentru psoriazis.
Pe de alta parte, exista mai multe tipuri de tratament care pot ameliora simptomele, precum unguentele speciale, fototerapia sau medicatia orala. Majoritatea cazurilor de psoriazis sunt usoare si nu necesita pentru tratament decat folosirea anumitor unguente tratamentul local. Formele severe sunt greu de tratat si deseori necesita administrarea tratamentului oral medicamentos.
Psoriazisul, indiferent de tipul acestuia, este o boala recidivanta revine, la un anumit interval de timp. Scopul tratamentului este reducerea cresterii accentuate a tesutului cutanat placilor si a inflamatiei secundare acesteia. Tratamentul psoriazisului se realizeaza in functie de tipul si gravitatea bolii in functie de localizarea leziunilor cutanate, extinderea lor, complicatii, boli asociate.
Pe langa componenta fizica afectare cutanata, articularatrebuie sa luam in calcul si componenta de ordin psihic frustrare sau depresie secundara aspectului fizic neplacutastfel ca in unele cazuri poate fi necesar tratamentul psihiatric psihoterapie, medicatie antidepresiva.
Poate aparea in orice zona a corpului. Poate aparea dupa o infectie bacteriana sau virala sau dupa administrarea unor medicamente de exemplu, acid salicilic. Zona afectata va fi iritata si accentuata de transpiratie sau de care trateaza unghiile psoriazis pielii. Acest tip de psoriazis apare in gutele pielii, in special in zona axilara, piept sau abdomen. Veziculele nu sunt infectate si pot fi localizate pe maini, picioare sau se pot intinde pe tot corpul.
Roseata si inflamatia apar pe coate, maini, genunchi, picioare, solduri si coloana vertebrala. Implica dureri si rigiditatea articulatiilor. Unghiile se pot ingrosa, devin galbui si sunt friabile. DERMATITA Dermatita este o afectiune frecvent intalnita, caracterizata prin inflamarea pielii si prurit. Boala nu este grava, dar poate provoca disconfort daca nu este tratata corespunzator. Simptomele si semnele comune de dermatita includ: Primul meu bebelus Annabell.
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See related patient information handout on psoriasiswritten by the authors of this article. Psoriasis is characterized by red, thickened plaques with a silvery scale. The lesions vary in size and degree of inflammation. Psoriasis is categorized as localized or care trateaza unghiile psoriazis, based on the severity of the care trateaza unghiile psoriazis and care trateaza unghiile psoriazis overall impact care trateaza unghiile psoriazis the patient's quality of life and well-being.
Patient education about the disease and the treatment options is important. Medical treatment for localized psoriasis begins with a combination of topical corticosteroids and coal tar or calcipotriene.
For lesions that are difficult to control with initial therapy, anthralin or tazarotene may be tried. The primary goal of therapy is to care trateaza unghiile psoriazis control of the lesions.
Cure is seldom achieved. If control becomes difficult or if psoriasis is generalized, the patient may benefit from phototherapy, systemic therapy and referral to a physician who specializes in the treatment of psoriasis.
Psoriasis affects about 2 percent of the U. Inpsoriasis was the reason for more than 1 million visits to physicians. This article describes an algorithmic treatment approach for primary care physicians. The algorithm is based on treatment guidelines for psoriasis published care trateaza unghiile psoriazis the American Academy of Dermatology, 3 supplemented by a review of the medical literature. There currently are no evidence-based guidelines for the treatment of psoriasis. Because localized plaque psoriasis is the most common form, the algorithm focuses on the treatment of this type of psoriasis.
The primary cause of psoriasis remains unknown. Abnormal epidermal cell kinetics and abnormal activation of immune mechanisms are thought to be the major contributors, and treatment may affect one or both of these mechanisms. The primary lesion care trateaza unghiile psoriazis a well-demarcated erythematous plaque with a silvery scale. Characteristically, psoriasis is symmetrically distributed, with lesions frequently located on the ears, elbows, knees, umbilicus, gluteal cleft and genitalia Figure 1.
The joints psoriatic arthritisnails and scalp may also be affected. Common areas of distribution of psoriasis. The lesions are usually care trateaza unghiile psoriazis distributed and are characteristically located on the ears, elbows, knees, umbilicus, gluteal cleft and genitalia.
Itching is the most common symptom, 4 and extensive scratching can often lead to superimposed lichen simplex chronicus. In some patients, burning and pain may be the only symptoms. Psoriasis can be classified into care trateaza unghiile psoriazis types: The less common forms of care trateaza unghiile psoriazis Cel mai bun psoriazis pustular localized and generalized and erythrodermic variants.
Care trateaza unghiile psoriazis most common form is plaque-type psoriasis Figure 2. The scale itself is variable, ranging from a thick, massive scale, as is generally seen on the scalp, to no scale at all, as is generally seen in intertriginous or partially treated areas. Atopic dermatitis, irritant dermatitis, cutaneous T-cell lymphoma, pityriasis rubra pilaris, seborrheic dermatitis.
Teardrop-shaped, pink to salmon, scaly plaques; usually on the trunk, with sparing of palms and soles. Erythematous papules or plaques studded with pustules; usually on palms or soles known as palmoplantar pustular psoriasis. Same as localized with a more general involvement; may care trateaza unghiile psoriazis associated with systemic symptoms such as fever, malaise and diarrhea; patient may click to see more may not have had preexisting psoriasis.
Severe, bicarbonat de sodiu si psoriazis, generalized erythema and scaling covering entire body; often associated with systemic symptoms; may or may not have had preexisting psoriasis.
Drug eruption, eczematous dermatitis, mycosis fungoides, pityriasis rubra pilaris. A primary lesion of plaque-type psoriasis. The typical lesion is a well-demarcated, thick, erythematous plaque with a silvery scale.
Guttate psoriasis is characterized by numerous small, oval teardrop-shaped lesions that develop after an acute upper respiratory tract infection. These lesions are often not as scaly or as red as the classic lesions of plaque-type psoriasis. Usually, guttate psoriasis must be differentiated from pityriasis rosea, another condition characterized by the sudden outbreak of red scaly lesions. Compared with pityriasis rosea, care trateaza unghiile psoriazis lesions are thicker and scalier, and the lesions are not usually distributed along skin creases.
The diagnosis of psoriasis can usually be made on the basis of the clinical presentation; histologic confirmation is rarely needed. If the diagnosis is uncertain, a biopsy can be performed or consultation care trateaza unghiile psoriazis a dermatologist can be obtained. Once the diagnosis of psoriasis is made, patient education about the disease should begin.
Points that should be emphasized about the disease initially include its noncontagious nature and the possibility of controlling but not curing it. Patients should also be assured that psoriasis is quite common. Exacerbating factors should be discussed, including stress, infection, trauma, xerosis and use of medications such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, lithium and the antimalarial agent hydroxychloroquine Plaquenil. The National Psoriasis Foundation is a widely used resource for patients More info site: An algorithm for the treatment of localized psoriasis is depicted in Figure 3.
Localized psoriasis can be defined as disease that is limited to such a degree that topical therapy controls it. Generalized psoriasis may require oral care trateaza unghiile psoriazis, treatment with ultraviolet light or treatment at an outpatient or inpatient care trateaza unghiile psoriazis. Algorithm for the treatment of localized psoriasis. Treatment of localized psoriasis is initiated using topical corticosteroids, alone or in combination with coal tar or calcipotriene.
Patients with resistant lesions may benefit from the addition of anthralin or tazarotene. The treatment of psoriasis requires an understanding of the effect that psoriasis is having on the patient's quality of life, and that effect is extremely variable. Taking the individual patient's treatment needs into consideration care trateaza unghiile psoriazis improve the overall outcome. Topical therapy, including corticosteroids, calcipotriene Dovonexcoal tar products, tazarotene Tazorac and anthralin Anthra-Derm care trateaza unghiile psoriazis, is the mainstay of treatment for localized disease Tables 2 and 3.
While the use of emollients should be encouraged, they should be used selectively because many e. Low-potency corticosteroids classes 6 and 7such as desonide Desowenaclometasone dipropionate Aclovate ; hydrocortisone agents Cortizone, Cortaid, care trateaza unghiile psoriazis. Medium-potency corticosteroids classes 3, 4 and 5such as triamcinolone acetonide Kenaloghydrocortisone valerate Care trateaza unghiile psoriazisfluticasone propionate Cutivatehalcinonide Halogmometasone furoate Elocon.
High-potency corticosteroids classes 1 and 2such as halobetasol propionate Ultravateclobetasol propionate Temovatediflorasone diacetate Psorconbetamethasone dipropionate Diproleneclobetasole propionate Cormax. Anthralin Anthra-Derm, Drithocreme, Dritho-Scalp, Miconal. Side effects increase with increased potency, duration of therapy and total dosage.
For onycholysis, a topical corticosteroid in a solution vehicle may be used under the nail. Systemic therapy may be care trateaza unghiile psoriazis to improve severe disease. The thin skin of the genitalia is highly sensitive to the adverse care trateaza unghiile psoriazis atrophy of topical corticosteroids.
A low-potency topical corticosteroid ointment is recommended. Topical calcipotriene, which is not associated with a risk of atrophy, may be used. The thick stratum corneum of palms and soles is a barrier to penetration of topical agents.
A highest-potency topical corticosteroid is recommended. Methotrexate Rheumatrex or acitretin Soriatane; a systemic retinoic acid analog may be needed. Topical corticosteroids are the sind Psoriazis unguent golyuka mit commonly prescribed treatment for psoriasis. Corticosteroids have well-recognized anti-inflammatory and antiproliferative effects, which are thought to be their primary mechanism of action in psoriasis.
In general, treatment is initiated with a medium-strength agent, and high-potency agents are reserved for the treatment of thick chronic care trateaza unghiile psoriazis that are refractory to weaker steroids. Low-potency agents are used on the face, on areas where the skin tends to be thinner, and care trateaza unghiile psoriazis the groin and axillary areas, where natural occlusion increases the potency of a low-potency agent to the care trateaza unghiile psoriazis of a higher potency agent.
Use of high-potency agents in these areas increases the risk of side effects and therefore should be avoided. Care trateaza unghiile psoriazis side effects from corticosteroids include cutaneous atrophy, telangiectasia and striae, acne eruption, glaucoma, hypothalamus-pituitary-adrenal axis suppression and, in children, growth retardation.
The true incidence of corticosteroid-induced hypothalamus-pituitary-adrenal suppression is unknown, but it is of concern with prolonged use. Careful long-term follow-up of patients receiving topical corticosteroid therapy is highly recommended to detect potential complications. Care trateaza unghiile psoriazis corticosteroids are rapidly effective in the treatment of psoriasis, they are associated with a rapid flare-up of disease after discontinuation, and they have many potential side effects.
Consequently, topical corticosteroids are frequently used in conjunction with another agent care trateaza unghiile psoriazis maintain control.
Topical calcipotriene is often used in combination care trateaza unghiile psoriazis topical corticosteroids to speed clearing of the care trateaza unghiile psoriazis and maintain control after the initial phase of treatment is completed.
Calcipotriene is a vitamin D 3 analog available in cream, ointment and solution formulations. It inhibits epidermal cell proliferation and enhances normal keratinization.
This agent has a slow onset of action, and patients should be aware that the effects of calcipotriene may not be noticeable for up to six to eight weeks after the initiation of therapy.
Although calcipotriene monotherapy has care trateaza unghiile psoriazis shown to be moderately effective in reducing the thickness, scaliness and erythema of psoriatic lesions, 8 maximal benefits are achieved when calcipotriene is used care trateaza unghiile psoriazis combination with potent topical corticosteroids.
This second phase helps prevent rebound from abrupt withdrawal of corticosteroids. When the lesions have remained flat and the intensity of their color has declined from bright red to pink, the maintenance phase begins, with use of calcipotriene alone and discontinuation of the weekend use of topical corticosteroids.
After appropriate control of the disease is maintained, topical therapy can be discontinued until a flare-up occurs. Use of emollients should be recommended, to reduce the scaly appearance of the lesions and to potentially reduce the amount of corticosteroid needed. The only cutaneous side effect of calcipotriene is local irritation, care trateaza unghiile psoriazis occurs in approximately 15 percent of patients.
Hypercalcemia is a potential side effect of this agent when the dosage exceeds g per week. This effect does not usually occur with weekly use of g or less.
For localized psoriasis, the recommended dosages do not require monitoring of serum or urinary calcium levels. However, calcipotriene should be used with caution in patients with compromised renal function or a history of renal calculi. Coal tar is a black viscous fluid that was first described by Goeckerman inwhen it was combined with ultraviolet light for the treatment of psoriasis. It is thought to suppress epidermal DNA synthesis.
Coal care trateaza unghiile psoriazis is available as an ointment, cream, lotion, shampoo, bath oil and soap. Coal tar is most effective when it is used in combination with other agents, especially ultraviolet B light.
Like calcipotriene, coal tar is effective when it is combined with topical corticosteroids. Coal tar shampoo can be used in combination with a care trateaza unghiile psoriazis scalp solution for the treatment of psoriasis on the scalp.
Because coal tar is messy and malodorous and can stain clothing, nighttime application is recommended. Patients should be advised to use old bed linens and and to wear old pajamas when they are using coal tar. Tar products can cause folliculitis, but they otherwise are generally not associated with side effects. Source good control of psoriasis is not achieved with topical corticosteroids, alone or in combination with calcipotriene or coal tar, consideration should be given to the addition of anthralin or tazarotene therapy.
Anthralin, also known as dithranol, is an antipsoriatic topical preparation derived from wood tar. Anthralin is available in 0. It is generally used on notably thick, large plaques of psoriasis, and therapy is initiated at low concentrations for short periods. The concentration and duration of contact with each treatment is gradually increased, up to a maximum of 30 minutes per application.
Patients should be warned that anthralin has a tendency to stain any surface, including the skin, clothing and bathtub. Its use should be limited to well-demarcated plaques, and it should be applied with a cotton-tipped applicator or a gloved hand. Care trateaza unghiile psoriazis should be warned that normal skin surrounding the psoriatic lesion may become irritated if it comes in contact with anthralin. Topical tazarotene is the first topical receptor-selective retinoid approved for the treatment of psoriasis.
It is care trateaza unghiile psoriazis only in gel form and exerts its effects through gamma and beta retinoic acid receptors. Tazarotene helps to normalize the proliferation and differentiation of keratinocytes, as well as to decrease cutaneous inflammation. As monotherapy, tazarotene has been shown to significantly reduce plaque care trateaza unghiile psoriazis in mild to moderate psoriasis.
The primary side effect of topical tazarotene is minor skin irritation and increased photosensitivity. Tazarotene is classified as a pregnancy category X drug and its use should be avoided in women of childbearing age. Sun exposure in addition to topical therapy may be beneficial when care trateaza unghiile psoriazis areas are affected with psoriasis. Patients should be encouraged to obtain natural sunlight exposure or tanning-bed light exposure for a few minutes a day, and then to slowly increase the duration of exposure as tolerated.
Unaffected areas should be covered with a sunscreen, especially the face. Ultraviolet light check this out can be used judiciously to prevent flare-ups during the maintenance phase of therapy. Psoriatic plaques that fail to respond to topical therapy may be improved by administration of intralesional corticosteroid injections.
Triamcinolone Kenalog is often used for this purpose. The agent is injected directly into the dermis of a small, persistent plaque. The concentration Tratamentul psoriazisului generally 3 to 10 mg per mL, depending on the size, thickness and area of the lesion.
The dose care trateaza unghiile psoriazis triamcinolone is released gradually over three to four weeks; additional injections may be needed every four to six weeks to improve the response. Disadvantages of intralesional injections include pain during the injection and potential side effects of local atrophy and systemic absorption. The patient with refractory lesions may benefit from more advanced forms of treatment, such as phototherapy ultraviolet B alone or psoralens plus ultraviolet Aoutpatient treatment at a clinic specializing in psoriasis and systemic therapy with oral retinoids, methotrexate Rheumatrex or cyclosporine Sandimmune.
Combination therapy has also been shown to be effective, especially phototherapy in combination with topical anthralin, coal tar or calcipotriene Table 4. Used for many years, highly effective. May cause acute phototoxicity. Little to no long-term side effects. UVB can be used at home for care trateaza unghiile psoriazis therapy. Highly effective; can be used as maintenance therapy. High risk of acute phototoxicity. Long-term risks include high risk of cutaneous malignancy. Moderately effective; best for pustular psoriasis.
Potent teratogen; use in women of childbearing potential should be avoided. Causes dryness of skin. May cause elevation of triglycerides. Hyperostosis with long-term use. Highly effective and can be used on a long-term basis. Should not be used in noncompliant patients or when there is preexisting hepatic disease. Can cause acute care trateaza unghiile psoriazis chronic hepatotoxicity, and acute neutropenia and pancytopenia.
The long-term risk of renal toxicity, which may not be detectable by blood tests, limits long-term use. Frequently used or well-studied combination therapies. In this web page cases, the therapeutic goal is to maximize treatment efficacy and the patient's quality of life, while minimizing side effects.
Achieving and maintaining control of psoriatic lesions is the central goal in treatment. Physicians and patients need to understand that there is no definitive cure for psoriasis Figure 4.
Control of the disease may mean that lesions in psoriazisului Tratamentul inghinala regiunea not as thick or as red as they were before treatment, but some degree of erythema may remain. Most often, treatment does not result in complete clearing of the lesions.
A care trateaza unghiile psoriazis lesion of psoriasis. The goals of treatment for localized psoriasis include a decrease in the size and redness of the plaque, as well as a reduction in the amount of scale on the lesion.
Care trateaza unghiile psoriazis with the lesion in Figure 2this lesion is flat, and the scale is not obvious. It does retain mild redness. This is the result that should be expected in the treatment of localized psoriasis. Although the algorithm serves as a guide to the treatment of localized psoriasis, various paths can be taken to achieve control of localized disease. The treatment path should be care trateaza unghiile psoriazis on a patient-to-patient basis.
As mentioned previously, generalized psoriasis may require more complex forms of therapy. Consultation with a dermatologist may be beneficial for patients who require such therapy. Already a member or subscriber? She is a graduate of West Virginia University School of Medicine, Morgantown. He graduated from Duke University School of Medicine, Durham, N.
Feldman completed a dermatology residency at the University of North Carolina, Chapel Hill. He is a member of the editorial board of the Journal of the American Academy of Dermatolog y.
She completed undergraduate training at the University of North Carolina, Chapel Hill, and physician assistant training at Emory University School of Medicine, Atlanta.
Address correspondence to Asha G. Reprints are not available from the authors. Feldman has received honoraria from Westwood-Squibb Pharmaceuticals and Glaxo Wellcome, Inc. Fleischer AB Jr, Care trateaza unghiile psoriazis SR, Bradham DD.
Office-based physician services provided by dermatologists in the United States in Fleischer AB Jr, Feldman SR, Rapp SR, Reboussin DM, Exum ML, Clark AR, et al. Disease severity measures in a population of psoriasis patients: American Academy of Dermatology. Committee on Guidelines of Care, Task Force on Psoriasis. Cât de des pentru a lua duș of care for psoriasis. J Am Acad Dermatol. Lebwohl M, Abel E, Zanolli M, Koo J, Drake L.
Topical therapy for psoriasis. Mechanism of glucocorticoid action. J Fla Med Assoc. Walsh P, Aeling JL, Huff L, Weston WL. Hypothalamus-pituitary-adrenal axis suppression by superpotent topical steroids.
Dubertret L, Wallach D, Souteyrand P, Perussel M, Kalis B, Meynadier J, et al. Efficacy and safety of calcipotriol MC ointment in psoriasis vulgaris: Sequential therapy for psoriasis. Vitamin D 3 analogues. Kragballe K, Gjersten BT, De Hoop D, Karlsmark T, van de Kerkhof PC, Larko O, et al. Cunliffe WJ, Berth-Jones J, Claudy A, Fairiss G, Goldin D, Gratton D, et al. Comparative study of calcipotriol MC ointment and betamethasone valerate ointment in patients with psoriasis vulgaris.
UVB phototherapy and coal tar. Foster RH, Brogden RN, Benfield P. Duvic Care trateaza unghiile psoriazis, Asano AT, Hager C, Mays S. The pathogenesis of psoriasis and the mechanism of action of tazarotene. Weinstein GD, Krueger GG, Lowe NJ, Duvic M, Freidman DJ, Jegasothy BV, article source al.
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Want to use this article elsewhere? Urinary Tract Infections During Pregnancy. An Algorithm-Based Approach for Primary Care Physicians. Feb 1, Issue. Abstract Diagnosis Topical Therapy Intralesional Injections, Phototherapy and Systemic Therapy Goals of Therapy and When to Refer References.
Article Sections Abstract Diagnosis Topical Therapy Intralesional Injections, Phototherapy and Systemic Therapy Goals of Therapy and When to Refer References. Types of Psoriasis, Associated Findings and Treatment Options Type of psoriasis Clinical features Precipitating factors Differential diagnosis Treatment options Plaque-type psoriasis Red, thick, scaly lesions with silvery scale Stress, infection, trauma, medications, xerosis Atopic dermatitis, irritant dermatitis, cutaneous T-cell lymphoma, pityriasis rubra pilaris, seborrheic dermatitis Localized: Treatment of Localized Psoriasis FIGURE 3.
Treatment of Psoriasis in Problem Areas Site Special problem Treatment options Scalp Hair-bearing areas are not receptive to ointment vehicles. Nails The thick keratin of the nail blocks absorption of topical agents. Genitalia The thin skin of the genitalia is highly sensitive to the adverse effects atrophy of topical corticosteroids. Palms and soles The thick stratum corneum of palms and soles is a barrier to penetration of topical agents.
Therapy for Generalized Psoriasis Therapy Characteristics that guide care trateaza unghiile psoriazis choice of therapy Care trateaza unghiile psoriazis B UVB light Used for many years, highly effective.
Psoralen plus ultraviolet A PUVA Highly effective; can be used as maintenance therapy. Retinoids acitretin [Soriatane] Moderately effective; best for pustular psoriasis.
Methotrexate Rheumatrex Highly effective and can be used on a long-term basis. Cyclosporine Sandimmune Highly effective. Frequently used or well-studied combination therapies UVB plus topical calcipotriene Dovonex UVB plus topical coal tar PUVA plus topical calcipotriene PUVA plus retinoids Acitretin plus topical calcipotriene Cyclosporine plus topical calcipotriene Infrequently used or less well-studied therapies UVB plus methotrexate PUVA plus methotrexate.
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To see the full article, log in or purchase access. The Authors show all author info ASHA G. More in Pubmed Citation Related Articles. MOST RECENT ISSUE Aug 1, Access the latest issue of American Family Physician Read the Issue. Email Alerts Don't miss a single issue. Sign up for the free AFP email table of contents. Care trateaza unghiile psoriazis reading from February 1, Previous: Urinary Tract Infections During Pregnancy Next: Red, thick, scaly lesions with silvery scale. Stress, infection, trauma, medications, xerosis.
Pityriasis rosea, secondary syphilis, drug eruption. Ultraviolet B phototherapy, natural sunlight. Pustular drug eruption, dyshidrotic eczema, subcorneal pustular dermatosis. Same as for plaque-type psoriasis. Pustular drug eruption, subcorneal pustular dermatosis.
Emollients Moisturel, Cetaphil, Curel, Nivea, etc. Duration of safe use unknown. Super-high potency safe for up to 4 weeks. Safe for up to 52 weeks; pregnancy category C. Hair-bearing areas are not receptive to ointment vehicles. The thick keratin of the nail blocks absorption of topical agents. Ultraviolet B UVB light. Psoralen plus ultraviolet A PUVA. UVB plus topical calcipotriene Dovonex. UVB plus topical coal tar. PUVA plus topical calcipotriene. Acitretin plus topical calcipotriene.
Cyclosporine plus topical calcipotriene. Infrequently used or less well-studied therapies. See My Options close Already a member or subscriber? Log in Best Value!
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