Belogent Psoriasis Bewertungen
Belogent Psoriasis Bewertungen information on medical topics, symptoms, drugs, procedures, news and more, written for the health care professional. Psoriasis is an inflammatory disease that manifests most commonly as well-circumscribed, erythematous papules and plaques covered belogent Psoriasis Bewertungen silvery scales.
Multiple factors contribute, including genetics. Common triggers include trauma, infection, and certain drugs. Symptoms are usually belogent Psoriasis Bewertungen, but mild to severe itching may occur. Cosmetic implications may http://ulf-roesener.de/subisedypu/psoriasis-exazerbation-stufe.php major.
Some people develop severe disease Leberreinigung zu Hause für Psoriasis painful arthritis. Diagnosis is based on appearance and distribution of lesions.
Treatment can include topical treatments eg, emollients, vitamin D analogs, retinoids, coal tar, anthralincorticosteroidsphototherapy, and, when severe, systemic drugs eg, methotrexateoral retinoids, cyclosporineimmunomodulatory agents [biologics].
Psoriasis is hyperproliferation of epidermal keratinocytes combined with inflammation of the epidermis and dermis. Peak onset is roughly bimodal, most often at ages 16 to 22 and at ages 57 to 60, but the disorder can occur at belogent Psoriasis Bewertungen age. The cause of psoriasis belogent Psoriasis Bewertungen unclear but involves immune stimulation of epidermal keratinocytes; T cells seem to play a central role.
Genomewide linkage analysis has identified numerous psoriasis belogent Psoriasis Bewertungen loci; the PSORS1 locus on chromosome 6p21 plays the greatest role in determining belogent Psoriasis Bewertungen patient's susceptibility of developing psoriasis. An belogent Psoriasis Bewertungen trigger is thought to evoke an inflammatory response and subsequent hyperproliferation of keratinocytes.
Drugs especially beta-blockers, chloroquinelithiumACE inhibitors, indomethacinterbinafine http://ulf-roesener.de/subisedypu/psoriasis-und-bioptron.php, and interferon-alfa. Lesions are either asymptomatic or pruritic and are most often localized on the scalp, extensor surfaces of belogent Psoriasis Bewertungen elbows and knees, sacrum, Psoriasis Bewertungen commonly the belogent Psoriasis Bewertungen cleftand genitals.
The nails, eyebrows, axillae, umbilicus, and belogent Psoriasis Bewertungen region may also be affected. The disease can be widespread, involving confluent article source of skin extending between these regions.
Lesions differ in appearance depending on type. Lesions appear gradually and remit and recur spontaneously or with the appearance and resolution of triggers. Besides the patient's appearance, the belogent Psoriasis Bewertungen amount of time required to treat extensive skin or scalp lesions and to maintain clothing and bedding may adversely affect quality of life.
Gradual appearance of discrete, erythematous papules or plaques covered with thick, silvery, shiny scales. Topical corticosteroids of belogent Psoriasis Bewertungen effective potency, with or without vitamin D 3 analogs eg, calcipotriol.
Systemic immunosuppressant or immunomodulatory drugs eg, methotrexatecyclosporineTNF-alpha inhibitor. Psoriasis belogent Psoriasis Bewertungen http://ulf-roesener.de/subisedypu/stationaere-psoriasis-und-armee.php areas usually the inguinal, gluteal, axillary, inframammary, and belogent Psoriasis Bewertungen folds and the glans of the uncircumcised penis.
Abrupt appearance of multiple plaques 0. Systemic retinoids, topical corticosteroids, vitamin Belogent Psoriasis Bewertungen 3 analogs eg, calcipotriolsystemic immunosuppressant or immunomodulatory drugs eg methotrexatecyclosporineTNF-alpha inhibitor. Pitting, stippling, fraying, discoloration oil spot signand thickening of the nails, with or without separation of the nail plate onycholysis.
Systemic retinoids, vitamin D 3 analogs eg, calcipotrioltopical corticosteroids. Systemic retinoids or methotrexate. Gradual or sudden onset of diffuse erythema, usually in patients with plaque psoriasis possibly the first manifestation of erythrodermic psoriasis ; typical psoriatic plaques less prominent or absent.
Most commonly triggered by inappropriate use of topical or systemic corticosteroids or light therapy. Potent systemic drugs eg, methotrexatecyclosporineTNF-alpha inhibitor or intense topical therapy, sometimes as inpatient therapy.
Tars, anthralinand phototherapy likely to exacerbate the condition. Dermatophytoses potassium hydroxide wet mount should be done for any scaly plaques, especially if they do not have a classic appearance of eczema or psoriasis. Squamous cell carcinoma in situ Bowen diseaseespecially when on the trunk; this diagnosis should be considered for isolated plaques that do not respond to usual therapy.
Biopsy is rarely necessary and may not be diagnostic; however, it may be considered in cases where the clinical findings are not classic. Disease is graded as mild, moderate, or severe based on the body belogent Psoriasis Bewertungen area affected belogent Psoriasis Bewertungen how the lesions affect the patient's quality of life.
To be considered mild, usually Psoriasis Area and Severity Indexbut these systems are useful mainly in research protocols.
Treatment options are extensive and range from topical treatments eg, emollients, salicylic acid, coal tar, anthralincorticosteroids, vitamin D 3 analogs, calcineurin inhibitors, tazarotene to UV light therapy to systemic treatments eg, methotrexateoral retinoids, cyclosporineimmunomodulatory agents [biologics].
See the American Academy of Dermatology's clinical guideline for psoriasis. Corticosteroids are usually used topically but may be injected into small or recalcitrant lesions. Systemic corticosteroids may precipitate exacerbations or development of von Sammlung Kaukasische Psoriasis Kräuter psoriasis and should not be used to treat psoriasis.
Topical corticosteroids are used twice daily. Corticosteroids are most effective when used overnight under occlusive polyethylene coverings or incorporated into tape; a corticosteroid cream is applied without occlusion during the day.
Corticosteroid potency is selected according to the extent of involvement. As lesions abate, the corticosteroid should be applied less frequently or at belogent Psoriasis Bewertungen lower potency to minimize local atrophy, striae formation, and telangiectases. Belogent Psoriasis Bewertungen, after about 3 wk, an emollient should be substituted for the corticosteroid for 1 to 2 wk as a rest period ; this substitution limits corticosteroid dosage and prevents tachyphylaxis.
Topical corticosteroid use can be expensive because large quantities about 1 oz or 30 g are needed for each application when a large body surface area is affected. Topical corticosteroids applied for long duration to large areas of http://ulf-roesener.de/subisedypu/psoriasis-celandine-zu-behandeln.php body may cause systemic effects and exacerbate psoriasis.
For small, thick, localized, or recalcitrant lesions, high-potency corticosteroids are used with an occlusive dressing or flurandrenolide tape; these dressings are left on overnight and changed in the morning. Relapse after topical corticosteroids are stopped is often faster than with other agents. Vitamin D 3 analogs eg, calcipotriol [ calcipotriene ], calcitriol are topical vitamin D analogs that induce normal keratinocyte proliferation and differentiation; they can be used alone or in combination with topical corticosteroids.
Some clinicians have patients apply calcipotriol on belogent Psoriasis Bewertungen and corticosteroids on weekends. Calcineurin belogent Psoriasis Bewertungen eg, tacrolimuspimecrolimus are Fett von zu Hause in topical form and are generally well-tolerated.
They are not as effective as corticosteroids but may avoid the complications of corticosteroids when treating facial and intertriginous psoriasis. It is not clear whether they increase the risk of lymphoma and skin cancer. Tazarotene is a topical retinoid.
It is less effective than corticosteroids as monotherapy but is a useful adjunct. Other adjunctive topical treatments include emollients, salicylic acid, coal tar, and anthralin. Emollients include emollient creams, ointments, petrolatum, paraffin, and even hydrogenated vegetable cooking oils.
They reduce scaling and are most effective when applied twice daily and immediately after bathing. Lesions may appear redder as scaling decreases or becomes more transparent. Emollients are safe and should probably always be used for mild to moderate plaque psoriasis. Salicylic acid is a belogent Psoriasis Bewertungen that softens scales, facilitates their removal, and increases absorption of other belogent Psoriasis Bewertungen agents.
It belogent Psoriasis Bewertungen especially useful as a component of scalp treatments; belogent Psoriasis Bewertungen scale can be quite thick.
Coal tar preparations are anti-inflammatory and decrease keratinocyte hyperproliferation via an unknown mechanism. Ointments or solutions are typically applied at night and washed off in the morning.
Coal tar products can be used in combination with topical corticosteroids or with exposure to natural or artificial broad-band UVB light to nm in belogent Psoriasis Bewertungen increasing visit web page Belogent Psoriasis Bewertungen regimen. Shampoos should be left in for 5 to 10 min and then rinsed out. Anthralin is a topical antiproliferative, anti-inflammatory agent.
Its mechanism of action is unknown. Effective dose is 0. Anthralin may be irritating and should be used with belogent Psoriasis Bewertungen in intertriginous areas; it also stains. Irritation and staining can be avoided by washing off the anthralin 20 to 30 min after application. Using belogent Psoriasis Bewertungen liposome-encapsulated preparation may also avoid some disadvantages of anthralin. UV light therapy is typically used in patients with extensive psoriasis.
The mechanism of action is belogent Psoriasis Bewertungen, although UVB light reduces DNA synthesis and can induce mild systemic immunosuppression. PUVA has an antiproliferative effect and also helps to normalize keratinocyte differentiation. Doses of light are started low and increased as tolerated. Severe burns can result if the dose of drug or UVA is too high. Although the treatment is less messy than topical treatment and may produce remissions lasting several months, repeated treatments may increase the incidence of UV-induced skin cancer and melanoma.
Excimer laser therapy is a type of phototherapy using a nm laser directed at focal psoriatic plaques. Methotrexate taken orally is an effective treatment for severe disabling psoriasis, especially severe psoriatic arthritis or widespread erythrodermic or pustular psoriasis unresponsive to topical agents or UV light therapy narrowband UVB [NBUVB] or psoralen plus ultraviolet A PUVA.
Belogent Psoriasis Bewertungen seems to interfere with the rapid proliferation of epidermal cells. Hematologic, renal, and hepatic function should be monitored.
Dosage regimens vary, so only physicians belogent Psoriasis Bewertungen in its use for psoriasis should undertake methotrexate therapy. Systemic retinoids eg, acitretinisotretinoin may be effective for severe and recalcitrant cases of psoriasis vulgaris, pustular psoriasis in which isotretinoin may be preferredand hyperkeratotic palmoplantar psoriasis. Because of the teratogenic potential and long-term retention of acitretin in the body, women who use it must not be pregnant belogent Psoriasis Bewertungen should be warned against becoming pregnant for belogent Psoriasis Bewertungen least 2 yr after treatment ends.
Pregnancy restrictions also apply to isotretinoinbut the agent is not belogent Psoriasis Bewertungen in the belogent Psoriasis Bewertungen beyond 1 mo. Long-term treatment may cause diffuse idiopathic skeletal hyperostosis DISH. Immunosuppressants can be used for severe psoriasis. Cyclosporine is a commonly used immunosuppressant. It belogent Psoriasis Bewertungen be limited to courses of several months rarely, up to 1 yr and alternated with other therapies.
Its effect on the kidneys and potential long-term effects on the immune system preclude more liberal use. Other immunosuppressants eg, hydroxyurea6- thioguaninebelogent Psoriasis Bewertungen mofetil have narrow safety belogent Psoriasis Bewertungen and are reserved for severe, recalcitrant psoriasis.
Immunomodulatory agents biologics—see Immunotherapeutics include TNF-alpha inhibitors etanerceptadalimumabinfliximab. TNF-alpha inhibitors lead to clearing belogent Psoriasis Bewertungen psoriasis, but their safety profile is still under study. Efalizumab is no longer available in the US due to increased risk of progressive multifocal leukoencephalopathy.
An Expert's Advice: What To Do If You Have Psoriasis | NIH MedlinePlus the Magazine Belogent Psoriasis Bewertungen
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