psoriasis.ppt skin care presentation pppp

Ppt

1. PSORIASISPSORIASIS
IDENTIFICATION AND IDENTIFICATION AND
MANAGEMENTMANAGEMENT

2. How can psoriasis present?How can psoriasis present?
•Plaques
•Flexural
•Guttate
•Scalp
•Hands and feet
•nails

3. Plaque psoriasisPlaque psoriasis

4. Guttate psoriasisGuttate psoriasis

5. Flexural psoriasisFlexural psoriasis

6. Scalp psoriasisScalp psoriasis

7. Nail psoriasisNail psoriasis

8. Hand and foot psoriasisHand and foot psoriasis

9. Management- PlaquesManagement- Plaques
•Depends on amount of body surface affected.
•Consider psychological impact and discuss
•Emollient
•Topical vitamin d analogue +/- moderately
potent topical steroid short term.
•Caution regarding Dovobet
•Exorex for small multiple plaques
•review

10. Plaque continuedPlaque continued
•Dithranol an option if motivated and able
to apply correctly
•Limited response- consider UVB
•Systemic therapy- Methotrexate /
Neotigason
•Biological agents

11. Guttate psoriasisGuttate psoriasis
•May occur after a streptococcal throat
infection
•Often resolves after a few weeks
•Topical tar e.g. Exorex
•Mild topical steroid
•Consider referral for UVB if not improving

12. Flexural PsoriasisFlexural Psoriasis
•Often treated as thrush- look for clues
•Milder vitamin d analogue( tacalcitol /
calcitriol). Topical steroid ( clobetasone
butyrate)
•Reduce frequency when settled to
maintain control

13. Scalp psoriasisScalp psoriasis
•Challenging and requires dedication
•Psoriasis association advice sheet explains how
to apply treatments.
•Mild - tar based shampoo used twice a week
•Moderate - above+ calcipotriol or
betamethasone scalp application 2-3 times a
week
•Severe – salicylic acid/ coal tar applied and left
on overnight, comb out, wash then apply steroid/
vitamin d application.

14. Scalp cont’dScalp cont’d
•Maintain with 1-2 x a week vitamin d
analogue or weakest topical steroid that
will control + tar based shampoo.

15. Nail psoriasisNail psoriasis
•Exclude fungal infection- clippings
•Nothing works topically.
•Nail varnish for women

16. Hands and feetHands and feet
•Can be a challenge.
•Emollient – thicker and possibly urea based
•Salicylic acid to soften scale
•Potent topical steroid – ointment/ occlusion
•Vitamin d analogues bit impractical as need to
apply a thick layer
•Refer for PUVA and possibly systemic treatment

17. Pustular psoriasisPustular psoriasis
•Does not mean infection

18. Useful sources of informationUseful sources of information
•www.bad.org.uk
•www.pcds.org.uk
•www.psoriasis-association.org.uk
•www.dermnet.org.nz
•www.patient.co.uk