Senin, 18 Oktober 2010

Kulit merah mengelupas? Jangan-jangan Psoriasis...

Walaupun tidak sering, psoriasis cukup umum saya temukan di praktek. Mulai dari yang ringan dan setempat, hingga yang luas hampir ke seluruh permukaan kulit tubuh. Pastinya, penyakit yang satu ini bisa mengguras PD dan kesabaran bila terkena dalam bentuk yang parah/luas..

Mohon maaf artikelnya belum sempat saya translate ya.. 

Psoriasis

Psoriasis is a persistent skin disorder in which there are red, thickened areas with silvery scales, most often on the scalp, elbows, knees, and lower back. Some cases, of psoriasis are so mild that people don’t know they have it. Severe psoriasis may cover large areas of the body. Dermatologists can help even the most severe cases.
Psoriasis is not contagious and cannot be passed from one person to another, but it is most likely to occur in members of the same family.
What causes psoriasis?
The cause is unknown. However, recent discoveries point to an abnormality in the functioning of special white cells (T-Cells) which trigger inflammation and the immune response in the skin. Because of the inflammation, the skin grows too rapidly. Normally, the skin replaces itself in about 30 days, but in psoriasis, the process speeds up and replaces the skin in three to four days, and the signs of psoriasis develop.


Types of Psoriasis
Psoriasis comes in many forms. The most common form, called plaque psoriasis, begins with little red bumps. Gradually, these become larger, and scales form. While the top scales flake off easily and often, scales below the surface stick together. These small red areas can enlarge.
Scalp, elbows, knees, legs, arms, genitals, nails, palms, and soles are the areas most commonly affected by psoriasis. It will often appear in the same place on both sides of the body.
            Scalp psoriasis may be mistaken for dandruff.
            Nails with psoriasis frequently have tiny pits in them. Nails may loosen, thicken, or crumble, and are difficult to treat.
Inverse psoriasis occurs in the armpit, under the breasts, and in skin folds around the groin, buttocks, and genitals.
Guttate psoriasis usually affects children and young adults. It often starts after 
a sore throat with many small, red, scaly spots appearing on the skin. It frequently clears up by itself in weeks or a few months.
Up to 30% of people with psoriasis may have symptoms of arthritis and 5-10% may have some functional disability from arthritis of various joints. In some people, the arthritis is worse when the skin is very involved. Sometimes the arthritis improves when the condition of the patient’s skin improves.


How is psoriasis treated?
The goal is to reduce inflammation and to control shedding of the skin.
Moisturizing creams and lotions loosen scales and help control itching. Special diets have not been successful in treating psoriasis, except in isolated cases. 

Treatment is based on a patient’s health, age, lifestyle, and the severity of the psoriasis. Different types of treatments and several visits to your dermatologist may 
be needed.

Your dermatologist may prescribe medications to apply on the skin containing cortisone compounds, synthetic vitamin D analogues, retinoids (vitamin A derivative), tar, or anthralin. These may be used in combination with ultraviolet light. The more severe forms of psoriasis may require oral or injectable medications with or without light treatment.
 Ultraviolet light therapy may be given in a dermatologist’s office, a psoriasis center, or a hospital. 


Ultraviolet light B (UVB) — This treatment involves exposing the skin to a wavelength of ultraviolet light called UVB. It may be used alone or in combination with topical or systemic treatments. UVB is administered with a light box that surrounds the patient or a light panel in front of which the patient stands. It takes about 24 treatments over a two month period for clearing to occur. A new type of UVB treatment called “narrow-band” UVB may be used if patients do not respond to broadband UVB.
Important :  Avoid Aggravating Factors - The following is a list of aggravating factors to avoid if you have psoriasis:
·       Do not scratch the skin. In approximately 1/3 of people with psoriasis, an injury to the skin (for example a scrape, scratch or bad sunburn), can induce psoriasis in the area of the injury. This is called the “Koebner Phenomenon.”
·       Stress ; Alcohol ; Smoking
·       Infections (e.g. Strep infections / sore throat)
·       Certain drugs. For example; antimalarials, lithium, beta-blockers, antiotensin-converting, enzyme inhibitors, non-steroidal, anti-inflammatory drugs, iodine, digoxin and clonidine, have also triggered or aggravated psoriasis in certain individuals.

If you are on these medications, speak to your doctor to see if he/she feels that they might be contributing to your condition. Do not stop them without consulting your physician, since it is not always safe to stop them abruptly.

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