PapulosquamousPapulosquamousdermatosesdermatoses

•1-psoriasis1-psoriasis

Psoriasis is a chronic proliferative epidermal diseasePsoriasis is a chronic proliferative epidermal disease

PathogenesisPathogenesis

1-biochemical abnormalities1-biochemical abnormalities

2-immunologic abnormalities2-immunologic abnormalities

3-abnormal leucocytic function3-abnormal leucocytic function

HistopathologyHistopathology

1-parakeratosis1-parakeratosis

2-absent stratum granulosum2-absent stratum granulosum

3-acanthosis3-acanthosis

4-munro micro abscess4-munro micro abscess

5-elongation and edema of dermal papillae5-elongation and edema of dermal papillae

6-mononuclear infiltrate6-mononuclear infiltrate

Clinical pictureClinical picture

• Red papules & plaques covered with silver scalesRed papules & plaques covered with silver scales

• Sites: extensors, elbow, knee, scalp & nailsSites: extensors, elbow, knee, scalp & nails

Auspitz signAuspitz sign

Scraping of lesions with glass slide results in Scraping of lesions with glass slide results in removal of scales until thin membrane appears its removal of scales until thin membrane appears its scraping shows pin point bleeding . scraping shows pin point bleeding .

Clinical forms:Clinical forms:

• 1-punctate1-punctate

• 2-guttate2-guttate

• 3-discoid3-discoid

• 4-annular4-annular

• 5-gyrate5-gyrate

Types:Types:

• 1-flexural1-flexural

• 2-psoriasis of palm & sole2-psoriasis of palm & sole

• 3-erythrodermic3-erythrodermic

• 4-psoriasis of nail4-psoriasis of nail

• 5-psoriasis of scalp 5-psoriasis of scalp

• 6-pustular psoriasis6-pustular psoriasis

• 7-arthropathic psoriasis7-arthropathic psoriasis

Koebner phenomenonKoebner phenomenon

• Appearance of isomorphic pathologic lesions in Appearance of isomorphic pathologic lesions in traumatized uninvolved skin in psoriatic patient.traumatized uninvolved skin in psoriatic patient.

• Other diseases with koebner: LP, PRP, vitiligoOther diseases with koebner: LP, PRP, vitiligo

Treatment:Treatment:

• 1-topical1-topical

• Crude tarCrude tar

• Salicylic acidSalicylic acid

• CorticosteroidCorticosteroid

• CalcipotriolCalcipotriol

• 2-systemic2-systemic

• AcitretinAcitretin

• Immunosuppressive as methotrexateImmunosuppressive as methotrexate

• 3-phototherapy3-phototherapy

• PUVAPUVA

2-lichen planus2-lichen planus

Clinical pictureClinical picture

• Itchy flat topped polygonal violaceous papules Itchy flat topped polygonal violaceous papules with white lines (Wickham's striae)with white lines (Wickham's striae)

• Sites: flexors, glans penisSites: flexors, glans penis

Varieties of LP:Varieties of LP:

1-LP linearis1-LP linearis

2-LP annularis2-LP annularis

3-LP atrophicus3-LP atrophicus

4-LP hypertrophicus4-LP hypertrophicus

5-LP of palm & sole5-LP of palm & sole

6-lichen plano-pilaris6-lichen plano-pilaris

7- LP actincus7- LP actincus

8- LP of mucous membrane8- LP of mucous membrane

A-white streaks c-ulcerativeA-white streaks c-ulcerative

B-white plaquesB-white plaques

http://www.dermnet.com/Lichen-Planus/picture/5173

http://www.dermnet.com/Lichen-Planus-Oral/picture/5275

HistopathologyHistopathology

1-hyperkeratosis1-hyperkeratosis

2-focal hypergranulosis2-focal hypergranulosis

3-acanthosis3-acanthosis

4-liquefactive degeneration of basal layer4-liquefactive degeneration of basal layer

5-band like infiltrate5-band like infiltrate

TreatmentTreatment

• 1-topical1-topical• CorticosteroidCorticosteroid

• 2-systemic2-systemic• AntihistaminesAntihistamines

• Corticosteroid in 1-acute generalized casesCorticosteroid in 1-acute generalized cases

2-oral ulcerative2-oral ulcerative

3-severe itching3-severe itching

3-pityriasis rosea3-pityriasis rosea

• Clinical pictureClinical picture

• Begins with bright red oval patch (herald patch)Begins with bright red oval patch (herald patch)• After 5-15 days, discrete medallions oval patches After 5-15 days, discrete medallions oval patches

appears ,usually in trunk, neck,& proximal extremities, appears ,usually in trunk, neck,& proximal extremities, covered with fine scalescovered with fine scales

• Types:Types:

1-classical1-classical2-abortive2-abortive3-inverted3-inverted

EtiologyEtiology

1-infective agent1-infective agent

2-drug induced2-drug induced

3-autoimmune3-autoimmune

TreatmentTreatment

1-antihistamines1-antihistamines

2-calamine for pruritus2-calamine for pruritus

3-reassurance3-reassurance

4- pityriasis rubra pilaris(PRP)4- pityriasis rubra pilaris(PRP)

• Chronic skin disease characterized by diffuse & Chronic skin disease characterized by diffuse & follicular hyperkeratosisfollicular hyperkeratosis

• Clinical pictureClinical picture1- scaly scalp1- scaly scalp2-psoriatic-like patches2-psoriatic-like patches3-hyperkeratoses of palm & sole3-hyperkeratoses of palm & sole4-follicular hyperkeratosis4-follicular hyperkeratosis5-nails are brittle, rough & dystrophic5-nails are brittle, rough & dystrophic6- erythroderma with islands of normal skin 6- erythroderma with islands of normal skin

Types:Types:1-classical adult1-classical adult2-atypical adult2-atypical adult3-classical juvenile3-classical juvenile4-circumscribed juvenile4-circumscribed juvenile5-atypical juvenile5-atypical juvenile

TreatmentTreatment

• Topical steroidTopical steroid• Salicylic acidSalicylic acid• MethotrexateMethotrexate