Clinical Symptoms of Psoriasis
General condition is not affected, except in the erythrodermic psoriasis. Some patients complained of mild itching. Predilection spot on scalp, face scalp border, extremity, especially the extensors at the elbow and knee and lumbo sacral region.
Skin abnormalities consist of patchy erythema raised (plaque) with squama thereon. Circumscripta erythema and patchy, but the healing period in the middle is often erythema disappeared and exist only on the edge. Squama layered, rough and white as well as transparent mica. Of the abnormalities varies, can lenticular, nummular, plaque and can confluented. If all or most of the so-called psoriasis guttate lenticular shaped, usually in children, young adults and occurs after infection by Streptococcus.
Primary lesion in patients with skin psoriasis is bright red, papules and develop into reddish, demarcated plaques. Location of the plaque is generally found on the elbows, knees, scalp, umbilicus, and intergluteal. In psoriasis patients with dark skin, the distribution is almost the same, but the purple papules and plaques primarily to gray scales. The palms and soles of the feet, demarcated and containing sterile pustules and thickened at the same time.
In psoriasis there is a phenomenon of wax droplets, Auspitz and Kobner (isomorphic). The second phenomenon and Auspitz wax droplets are considered typical, while Kobner considered typical, only approximately 47% of the positive and is found also in other diseases., For example, Lichen Planus and juvenile Plana verruca. The phenomenon is squama wax droplets that change color to white on a scratched scratches like a candle, caused by changes in refractive index. Way to the edge of the glass can scratch pad. In the Auspitz phenomenon of serum or blood appears mottled due to papilomatosis. How to do this is by way of a multi-layered squama is scraped with the tip of a glass pedestal. Having exhausted the scrapping squama be done slowly because if it does not look too in the form of bleeding, but bleeding spots are evenly distributed. Trauma to the skin such as psoriasis sufferers of trauma due to scratching can cause a skin disorder called psoriasis and similar to the Kobner phenomena arising approximately after 3 weeks.
Psoriasis can also cause abnormalities of the nail as much as approximately 50% which is rather typical of the so-called nail or nail pitting pit in the form of curves billion. Abnormalities are not typical of the nail that is cloudy, thick, raised distal parts as there are below the stratum corneum (subungual hyperkeratosis) and onikolysis. Besides causing skin and nail disorders, the disease can also cause abnormalities in the joints. Polyarticular generally, where predilected place is interfalangs distal joints and most are at the age of 30-50 years. Enlarged joints then place ankylosis and subcortical cystic lesions. Mucosal abnormalities are uncommon.
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