POSRIASIS
A. INTRODUCTION
 Chronic inflammatory skin condition
 Autoimmune
 Well-dermarcated, erythematous plaques with “silver scale”
Psoriasis /səˈraɪəsɪs/: Bệnh vảy nến
- psora : itchy
- iasis : condition
Autoimmune /ˌɔːtəʊɪˈmjuːn/: Tự miễn
Demercate /ˈdiːmɑːkeɪt/: có ranh giới
Erytherma / ɛrɪˈθiːmə/: ban đỏ
Plaques /plæk/: mảng
Accelerate /əkˈseləreɪt/ tăng tốc
Skin replaced every 3-5 days instead of 28-30 days, so we have this
accelerated reproduction of skin cells and that’s what creates the redness
and the scaling, and the little white flakes like qlaque.
T-cell Dysfunction : ↑↑ TH cell 17 + Cytokines (An additional
Inflammatory Signal)
Regulatory T-cell: prevents autoimmune diseases in the first place
→ Suppressed T Regulatory
Acquired Immune : Miễn dịch thu
được
Alter microbiome: Sự thay đổi hệ vi
sinh trên bề mặt da
Dysfunction : sự hoạt động bất
thường
Regulatory T-cell /ˈreɡjələtəri/ : TB T
điều hòa
Suppressed /səˈpres/ Ức chế
B. ONSET & RISK FACTORS
Onset : Lúc bắt đầu, cơn cấp
Onset: Any ages (two peaks: 30-39, 50-69)
Obesity /əʊˈbiːsəti/: Béo phì
Risk Factors:
Malarial /məˈleəriəl/: Bệnh sốt rét
1. Family history
PSORS1 locus on MHC (Chromosome 6 p21
HLA-Cw6 (early-onset)
2. Smoking
3. Alcohol
4. Obesity
5. Medications
Beta blockers
Lithium
Chloroquine (and other anti-malarial medications)
6. Infections
Post-streptococcal (acute)
HIV
C. TYPES
1. Plaque Psoriasis
 The most common type
 Symmetrical distribution: If you see it on one
area on arm, you’ll generally see it on the same
area on the other arm.
 Scalp, Knees, Extensor surface of elbows,
gluteal cleft
 Worse in winter (Dryness, Lack of sunlight)
 Auspitz Sign (A little bit of the silver scale is
removed, there’s some bleeding)
Symmetrical /sɪˈmetrɪkl/: đối xứng
Scalp /skælp/ : da đầu
Elbow /ˈelbəʊ/ : khuỷu tay
Gluteal cleft : khe hở giữa mông
Auspitz Sign: Dấu hiệu giọt sương
máu
Guttate : Thể giọt (Falling to gutter)
Eruption /ɪˈrʌpʃn/ : Sự phát ban
Lesions /ˈliːʒn/ : Tổn thương
Trunk /trʌŋk/ :phần thân
2. Guttate Psoriasis
 Small acute eruption preceded by strep infection
 Lesions <1cm in diameter
 Trunk and Proximal Extremities
Proximal /ˈprɒksɪməl/ : gần nhất
Extremities /ɪkˈstreməti/ : Chi, đoạn
cuối
Pustular : Dạng mủ
Leukocytosis : Tăng bạch cầu
3. Pustular Psoriasis
 Possibly life-threatening
 Sudden onset with leukocytosis, malaise, fever,
hypocalcemia
 Triggers: Pregnancy, withdrawal of oral
glucocorticoids
4. Erythrodermic Psoriasis
 Head-to-toe generalized erytherma (more than
90% body surface area)
 Issues with sepsis and fluid loss due to issues
with barrier protection
 Desquamative Scale
5. Inverse Psoriasis (opposite of plaque)
 Occurs in skin folds
 No visible scaling
Malaise /məˈleɪz/ : Khó chịu
Hypocalcemia : Hạ calci máu
Withdrawal /wɪðˈdrɔːəl/ : ngừng
Generalized /ˈdʒenrəlaɪzd/: Toàn thân
Sepsis : Nhiễm trùng huyết (hệ thống)
Barrier Protection: Hàng rào bảo vệ
Issues /ˈɪʃuː/ : sự chảy máu, chảy mũ
Desquamative : tróc vảy da
Skin folds : Nếp gấp da
Pitting : rỗ
Arthritis /ɑːˈθraɪtɪs/ : Viêm khớp
6. Nail Psoriasis
 Pitting of the nail
 Can precede or proceed other forms of psoriasis
 More common in patients with psoriatic arthritis
D. TREATMENTS
Topical /ˈtɒpɪkl/ : Tại chỗ
Limited Disease
1. Topical Corticosteroids
2. Emollients
3. Calcitriol
Topical Retinoids
Severe Disease
1. Phototherapy
2. Retinoids
3. Methotrexate
4. Biologics
 Vitamin D
 Suppress TH 17
 Acts like cortisol → A natural Predinone without side effects
 40,000 IU every single day
 Cod Liver Oil = Vit D + Vit A + Omega-3 fatty acids (DHA,EPA)
 Bile Salts (TUDCA)
 Allow Vit D to work a lot better
 Directly modulate and control TH 17
 3 – 4 per day, take an empty stomach
Emollients /ɪˈmɒliənt/ : Kem dưỡng
ẩm
NO GLUTEN
FASTING
Phototherapy : Quang trị liệu
Biologics : Thuốc sinh học
Cod Liver Oil : Dầu gan cá tuyết
Fasting: ăn kiêng