By Lionel Fry
Thoroughly revised, this moment variation is an entire replace of the across the world acclaimed first variation of An Atlas of Psoriasis, written through Lionel Fry, one of many world's such a lot amazing dermatologists. Copiously illustrated in colour, together with new prime quality visible imagery only in the near past to be had, the atlas is designed to interchange the previous variation at the cabinets of dermatologists and dermatopathologists around the globe. just like the earlier variation, the e-book offers an authoritative overview of psoriasis, together with medical good points, websites and scientific styles, differential prognosis, psoriatic arthropathy, and remedy.
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Extra info for An Atlas of Psoriasis, Second Edition
The nature of the injury is not specific. The clinical appearance of psoriasis in the Koebner phenomenon follows the site of injury. It may follow friction from tight clothing (Figure 55), follow a linear scratch (Figure 56), or occur at the site of an operation (Figure 57). ERYTHRODERMIC PSORIASIS Figure 54 Guttate psoriasis which has evolved into the plaque form This term is used when all the skin is involved in the psoriatic process (Figure 58). The skin is bright red, but the scaling is different from that seen in chronic plaque.
There may or may not be some scale, but, if present, it is fairly adherent, unlike the lesions elsewhere on the trunk and limbs. 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).
In normal skin, it is found predominately in the basal layer whilst in psoriasis, it is found throughout the keratinocyte layer. More recently, two intracellular molecules (Nod 1 and Nod 2) have been found in epithelial cells and macrophages and they are also concerned with recognition of bacterial molecules. Nod 2 has been shown to recognize peptidoglycan of Gram-positive organisms. Once the bacterial motifs are recognized by the cell-surface and intracellular receptors, the cells will produce cytokines, which in advanced mammals will attract lymphocytes and APCs into the tissue, and the so-called adaptive immune response will follow (Figure 14).