مرض الصدفية جراحة

1. Psoriasis
DR : KHALED ALSAYANI

2. Psoriasis
 Psoriasis is a skin disorder that causes skin cells to multiply up to 10 times
faster than normal
 They can grow anywhere, but most appear on the scalp, elbows, knees,
and lower back
 Psoriasis can’t be passed from person to person

3. Symptoms
 The symptoms of psoriasis vary depending on the type you have. Some
common symptoms for psoriasis — include
 Plaques of red skin, often covered with silver-colored scales.
 itchy
 painful,
 sometimes crack and bleed.
 In severe cases, the plaques will grow and merge, covering large areas.

4. Symptoms
 Disorders of the fingernails and toenails, including
 discoloration and pitting of the nails.
 The nails may also crumble or detach from the nail bed.
 Plaques of scales or crust on the scalp.
 People with psoriasis can also get a type of arthritis called psoriatic
arthritis.
 It causes pain and swelling in the joints.

5. Types:
1- PUSTULAR PSORIASIS
 which causes red and scaly skin with tiny pustules on the palms of the
hands and soles of the feet.

6. 2- GUTTATE PSORIASIS
 which often starts in childhood or young adulthood, causes small, red
spots, mainly on the torso and limbs.

7. 3- INVERSE PSORIASIS
 which makes bright red, shiny lesions that appear in skin folds, such as the
armpits, groin, and under the breasts.

8. 4- ERYTHRODERMIC PSORIASIS
 which causes fiery redness of the skin and shedding of scales in sheets.

9. Causes
 No one knows the exact cause of psoriasis, but experts believe that it’s a
combination of things.
 Something wrong with the immune system causes inflammation,
triggering new skin cells to form too quickly.
 Normally, skin cells are replaced every 10 to 30 days.
 With psoriasis, new cells grow every 3 to 4 days.

10. Treatment
 Luckily, there are many treatments. Some slow the growth of new skin
cells, and others relieve itching and dry skin
 STEROIDS CREAM
 LIGHT THERAPY
 METHOTRAXATE
 RETINOIDS
 An enzyme inhibitor

11. types of light therapy.
 Ultraviolet light B (UVB)
 Sunlight
 Psoralen + UVA (PUVA)
 Laser Treatments
 Tanning beds
 LASER TREATMENT

12. Psoriatic Arthritis
 Psoriatic arthritis is a chronic progressive inflammatory joint disease that
can be associated with psoriasis
 The condition may affect both peripheral joints and the axial skeleton
causing pain, stiffness, swelling, and possible joint destruction.
 Psoriatic arthritis is considered a seronegative spondyloarthropathy.

14. Prevalence
 Occurs in 6%-42% of persons that have psoriasis
 Approximately 2% of the general population has psoriasis
 Psoriatic arthritis is estimated to have a prevalence of 0.1%-0.25% in the
US
 Equal prevalence in both males and females
 Can occur at any age but typically occurs between ages of 30-50 years old
 80-90% chance of having psoriatic arthritis if one of your first degree
relatives has the disorder

15. Clinical Presentation
 inflammation,
 pain,
 stiffness,
 swelling

16.  Bone, tendons, enthesis, cartilage, synovial membrane, skin, and nails may
all be affected by the condition.
 During the initial stages, it is the tendons, synovia, and articular capsule
that are primarily affected.
 As the condition progresses, tendon and bone become altered. Marked
joint destruction may occur in some individuals.

17. Five Clinical Presentations of Psoriatic
Arthritis
 Distal Interphalangeal Dominant
 Symmetric Arthritis
 Asymmetric Arthritis (70%)
 Spondylitis
 Arthritis Mutilans

18. Clinical Signs and Symptoms
 Skin lesions
 Nail lesions
 Arthritis
 Soft-tissue involvement
 Dactylitis
 Extraarticular features: Include iritis, urethritis, mouth ulcers, colitis, and
aortic valve disease

19. Medications
Mild Disease
 Non-steroidal Anti-Inflammatory Drugs (NSAIDS)
 Local Corticosteroid Injections
Moderate to Severe Disease
 Disease-Modifying antirheumatic drugs (DMARD)
 Anti-tumor necrosis factor

20. Causes
 Genetic
 Environmental
 Immunologic

21. Physical Therapy Management
 The patient should be referred to a rheumatologist immediately if
undiagnosed psoriatic arthritis is suspected.
 All patients with manifestations of arthritic type conditions should be
asked if they have any type of skin condition or patches of dry skin

22.  Physical therapy can play an important role in improving the life of a person
with psoriatic arthritis.
 education,
 improvement of range of motion,
 strengthening,
 general cardiovascular conditioning.
 UV therapy and modalities to decrease pain.
 Cryotherapy may help to reduce swelling and tenderness in affected joints.
 Heat may be used to relieve joint pain.
 Paraffin baths tend to be soothing for the hands and feet.
 Splinting may be of benefit to prevent deformity.