By Lionel Fry
Thoroughly revised, this moment version is an entire replace of the across the world acclaimed first version of An Atlas of Psoriasis, written by way of Lionel Fry, one of many world's so much distinctive dermatologists. Copiously illustrated in colour, together with new prime quality visible imagery only in the near past on hand, the atlas is designed to interchange the previous variation at the cabinets of dermatologists and dermatopathologists around the world. just like the past version, the booklet offers an authoritative evaluate of psoriasis, together with scientific positive factors, websites and scientific styles, differential prognosis, psoriatic arthropathy, and remedy.
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Additional info for An Atlas of Psoriasis, Second Edition
Psoriasis of the 51 AN ATLAS OF PSORIASIS scalp may present as discrete red raised scaly plaques, as found elsewhere on the trunk and limbs, or it may show diffuse scaling, or may present as very thick plaques of keratin with the scales growing along the hair shafts (Figure 85). Hair loss with psoriasis of the scalp (Figure 86) is the exception rather than the rule. It does, however, occur with severe psoriasis, particularly the erythrodermic form of the disease. The alopecia presents as a diffuse thinning of the hair in the most severely affected areas, and may occur all over the scalp in erythrodermic psoriasis.
Plaque psoriasis may occur on the palms and soles with or without plaque lesions elsewhere. The palms and soles may have discrete lesions (Figure 89) or there may be confluent involvement affecting all the plantar and palmar skin, including the digits (Figure 90). In the latter presentation, there is a sharp line of demarcation between the palmar and plantar involvement and the surrounding skin (Figure 91). Figure 84 A common site of scalp psoriasis, behind the ear 53 AN ATLAS OF PSORIASIS Figure 85 Thick scales of scalp psoriasis Figure 86 Hair loss in scalp psoriasis, an uncommon feature 54 SITES AND CLINICAL PATTERNS Figure 87 Psoriasis in the pubic area Figure 88 Guttate psoriasis on the palms Figure 89 Localized symmetrical lesions of psoriasis on the palms.
In some 60% of patients, the disease will begin before the age of 30. The incidence of presentation then gradually falls with age, but psoriasis may first appear in the eighth and ninth decades. As a general rule, the earlier the age of onset the worse the prognosis. SEX PREDILECTION Psoriasis affects males and females equally. 25 AN ATLAS OF PSORIASIS Figure 17 Symmetrical red plaques of psoriasis with minimal scaling Figure 18 Thick plaques, some with white, and others with gray scale Figure 19 Thick, white adherent scale on plaques Figure 20 Symmetrical thick white/gray adherent scale in untreated psoriasis 26 CLINICAL FEATURES Figure 21 Thick gray scales in untreated chronic plaque psoriasis Figure 22 Excoriation of a plaque converting a red, nonscaly surface into a white, scaly one Figure 23 Two similar red plaques of psoriasis.