Talk:Psoriasis

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PASI score

PASI stands for Psoriasis Area and Severity Index. PASI includes the amount of body surface area that is affected by psoriasis in addition to three major symptoms: redness, inflammation, and the thickness of the scale on the skin. A patient is given a PASI score from 0-72 where 0 means no psoriasis and 72 means the most severe psoriasis. A PASI score is given to a patient before treatment and then after treatment to determine the effectiveness of the therapy. The goal of successful psoriasis treatment is to reduce the PASI score as close to 0 (no psoriasis) as possible.

Ultraviolet info seems self-contradictory

Ultraviolet wavelengths are subdivided into UVA (380–315 nm), UVB (315–280 nm), and UVC (< 280 nm). Ultraviolet B (UVB) (315–280 nm) is absorbed by the epidermis and has a beneficial effect on psoriasis. Narrowband UVB (311 to 312 nm), is that part of the UVB spectrum that is most helpful for psoriasis.

Query: If UVA is from 380-315 nm, it includes 311-312 nm. So how come Narrowband UV (311 to 312 nm) is supposed to be UVB instead of UVA?

Answer: 380-315nm does not included 311-312nm. 311-312 is less than 315.

Vitamin D therapy in psoriasis.

Araugo OE, Flowers FP, Brown K.

Vitamin D therapy in psoriasis.

DICP. 1991 Jul-Aug;25(7-8):835-9. Review.

PMID 1659041

Morimoto S, Yoshikawa K.

Psoriasis and vitamin D3. A review of our experience.

Arch Dermatol. 1989 Feb;125(2):231-4.

Abstract

Psoriasis is associated with abnormally exaggerated epidermal cellular turnover. Recent studies showed that calcitriol (1,25-dihydroxyvitamin D3) a calcitrophic hormone, regulates terminal differentiation of basal cells of epidermal keratinocytes. We administered active forms of vitamin D3 in both oral and topical ways in an open-design study to patients with psoriasis vulgaris. Significant improvement was observed at the end of the study periods in these patients, especially in those treated with topical application of calcitriol. We also found a significant negative correlation between the severity of psoriasis and the basal serum level of 1 alpha,25-dihydroxyvitamin D but not with those of other calcium-related parameters in psoriatic patients. These data suggest that exogenous active forms of vitamin D3 are effective for treatment of psoriasis and that the endogenous 1,25-dihydroxyvitamin D level also may be involved in the development of this skin disease.

PMID 2536537

Kamangar F, Koo J, Heller M, Lee E, Bhutani T.

Oral vitamin D, still a viable treatment option for psoriasis.

J Dermatolog Treat. 2012 Jan 21. [Epub ahead of print]

PMID 22103655

Grace K. Kim, DO

The Rationale Behind Topical Vitamin D Analogs in the Treatment of Psoriasis; Where Does Topical Calcitriol Fit In?

J Clin Aesthet Dermatol. 2010 August; 3(8): 46–53.

PMCID PMC2945865

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945865/ </ref>

"The therapeutic use of vitamin D dates back to the 1930s when it was used as an oral agent for osteoporosis on a psoriasis patient who subsequently experienced clearing of psoriatic skin lesions.10 Dermatological application of topical vitamin D3 centers on the fact that the skin is both a site of initial vitamin D biosynthesis and a target for vitamin D3 activity causing modulation of keratinocytes and inflammatory mediators.11" [1]

Cites in above block quote:

10: Nagpal S, Lu J, Boehm MF

Review Vitamin D analogs: mechanism of action and therapeutic applications.

Curr Med Chem. 2001 Nov; 8(13):1661-79.

PMID 11562285

11: Wolverton SE.

Comprehensive Dermatologic Drug Therapy. 2nd Edition.

Philadephia, PA: Saunders Elsevier; 2007.

Mention the generic (calcitriol) along with the patented (calcipotriol)?

Moisturizers and emollients such as mineral oil, petroleum jelly, calcipotriol or calcitriol, and decubal (an oil-in-water emollient) were found to increase the clearance of psoriatic plaques. Emollients have been shown to be even more effective at clearing psoriatic plaques when combined with phototherapy.^[1] However, certain emollients have no impact on psoriasis plaque clearance or may even decrease the clearance achieved with phototherapy. The emollient salicylic acid is structurally similar to para-aminobenzoic acid (PABA), commonly found in sunscreen, and is known to interfere with phototherapy in psoriasis. Coconut oil, when used as an emollient in psoriasis, has been found to decrease plaque clearance with phototherapy.^[1] Medicated creams and ointments applied directly to psoriatic plaques can help reduce inflammation, remove built-up scale, reduce skin turnover, and clear affected skin of plaques. Ointment and creams containing coal tar, dithranol, corticosteroids (i.e. desoximetasone), fluocinonide, vitamin D₃ analogs (for example, calcipotriol or calcitriol), and retinoids are routinely used. The use of the finger tip unit may be helpful in guiding how much topical treatment to use.^[2]^[3]

References

^ ^a ^b Asztalos ML, Heller MM, Lee ES, Koo J (May 2013). "The impact of emollients on phototherapy: a review". J Am Acad Dermatol. 68 (5): 817–24. doi:10.1016/j.jaad.2012.05.034. PMID 23399460.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Cite error: The named reference Clarke2011 was invoked but never defined (see the help page).
^ Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, Gottlieb A, Koo JY, Lebwohl M, Lim HW, Van Voorhees AS, Beutner KR, Bhushan R; American Academy of Dermatology (2009). "Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies". J Am Acad Dermatol. 60 (4): 643–59. doi:10.1016/j.jaad.2008.12.032. PMID 19217694.{{cite journal}}: CS1 maint: multiple names: authors list (link)

penis imagery not necessary.

The Image of the penis with psoriasis on this article seems to be unnecessary and offensive given the article topic. Under WP:GRATUITOUS the image should be removed because the removal of the image would not cause the article to be less informative or less relevant.--207.74.26.1 (talk) 19:39, 18 February 2016 (UTC)[reply]

I agree. Penile psoriasis is uncommon and the image is not illustrative. JFW | T@lk 11:24, 22 February 2016 (UTC)[reply]

It is not uncommon but I agree with you about the unnecessary image.Vorticus (talk) 21:58, 1 May 2016 (UTC)[reply]

Note to TylerDurden

Sorry -- you are the one who is confused. Doc James's edit summary plainly referred to the section heading "Bibliography." It seems the doctor prefers the heading "Further reading." So be it. The See-also section was also removed at the same time, possibly by mistake and in any case without explanation. I have restored it. Wahrmund (talk) 19:21, 1 March 2016 (UTC)[reply]

See also sections are not generally recommended per WP:MEDMOS. The link you provide is only tangentially related IMO. Doc James (talk · contribs · email) 21:33, 1 March 2016 (UTC)[reply]

I can assure you I'm quite up to speed. =) TylerDurden8823 (talk) 02:19, 2 March 2016 (UTC)[reply]

[Asztalos2013-1] Asztalos ML, Heller MM, Lee ES, Koo J (May 2013). "The impact of emollients on phototherapy: a review". J Am Acad Dermatol. 68 (5): 817–24. doi:10.1016/j.jaad.2012.05.034. PMID 23399460.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[Clarke2011-2] Cite error: The named reference Clarke2011 was invoked but never defined (see the help page).

[3] Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, Gottlieb A, Koo JY, Lebwohl M, Lim HW, Van Voorhees AS, Beutner KR, Bhushan R; American Academy of Dermatology (2009). "Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies". J Am Acad Dermatol. 60 (4): 643–59. doi:10.1016/j.jaad.2008.12.032. PMID 19217694.{{cite journal}}: CS1 maint: multiple names: authors list (link)

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