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- Title
Brief Overview About Topical Treatment Of Psoriasis And Seborrehic Dermatitis.
- Authors
Ali Muhammad, Heba Hassan; Elsayed, Manal Mohamed; Elghareeb, Mohamed Ibrahim
- Abstract
Background: Psoriasis (Ps) is a chronic immune mediated cutaneous disease with a strong genetic predisposition. Its prevalence is 2% worldwide varying according to regions. Psoriasis is an immune mediated inflammatory disease with unknown etiology that may be associated with the defect in proliferation and differentiation of keratinocytes associated with inflammatory cell infiltration particularly consisting of T lymphocytes, macrophages, and neutrophils. Psoriasis affects 1–3% of the adult population with various extra cutaneous manifestations. In the United States, psoriasis affects approximately 3.2% of adults, 0.13% of children and the incidence is approximately 80 new cases per 100 000 person-years. Worldwide, approximately125 million people have psoriasis, and psoriasis prevalence is highly variable across regions, ranging from 0.5% in parts of Asia to as high as 8% in Norway. Psoriasis presents as well-defined erythematous plaques covered with silvery scales commonly over the scalp, extensors of extremity particularly over knees and elbows and lumbosacral region. Psoriasis is classified into two types. Type 1 psoriasis, which has a positive family history, starts before age 40 and is associated with HLA-Cw6; while type 2 psoriasis does not show a family history, presents after age 40, and is not associated with HLA-Cw6. Psoriasis can present with different morphology in the form of plaque, guttate, rupioid, erythrodermic, pustular, inverse, and psoriatic arthritis. Variation in a site is seen with the involvement of scalp, palmoplantar region, genitals, and nails. Any injury to the skin in patients with psoriasis in the form of either mechanical, chemical or radiational trauma induces lesions of psoriasis at that site which is called Koebner phenomenon. It indicates the activity of disease. Topical agents are used for mild disease and also as adjuvant to systemic therapy or phototherapy for moderate-to-severe psoriasis. The lesions` site, thickness and scaling, patient`s age, vehicle preferences and patient's needs must be taken into account to carefully select proper medication. For more severe disease, systemic treatment should be considered like methotrexate, cyclosporine A, acitretin and apremilast. Recently, biologic treatment have provided more safe and effective therapeutic options for psoriasis. Multiple biologic agents have been approved for psoriasis by FDA such as infliximab, etanercept, adalimumab, and ustekinumab.
- Publication
Journal of Pharmaceutical Negative Results, 2022, Vol 13, p4785
- ISSN
0976-9234
- Publication type
Article
- DOI
10.47750/pnr.2022.13.S07.596