Psoriasis Classification and external resources
A person whose back and arms are affected by psoriasis.
ICD-10	L40.
ICD-9	696
OMIM	177900
DiseasesDB	10895
MedlinePlus	000434
eMedicine	emerg/489  Dermatology:derm/365 plaque derm/361 guttate derm/363 nails derm/366 pustular Arthritis derm/918 Radiology radio/578 Physical Medicine pmr/120
MeSH	D011565

Psoriasis (pronounced /səˈraɪəsɪs/) (suh-RI-uh-sus) is a disorder which affects the skin and joints. It commonly causes red scaly patches to appear on the skin. The scaly patches caused by psoriasis, called psoriatic plaques, are areas of inflammation and excessive skin production. Skin rapidly accumulates at these sites and takes a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals. Psoriasis is hypothesized to be immune-mediated^[1][2] and is not contagious. Image File history File links Download high resolution version (480x640, 142 KB) Summary Created by my partner with a digital camera. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // L00-L99 - Diseases of the skin and subcutaneous tissue (L00-L08) Infections of the skin and subcutaneous tissue (L00) Staphylococcal scalded skin syndrome (L01) Impetigo (L02) Cutaneous abscess, furuncle and carbuncle (L03) Cellulitis (L04) Acute lymphadenitis (L05) Pilonidal cyst (L08) Other local infections of skin and subcutaneous tissue (L081) Erythrasma... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... This article is about the organ. ... For other uses, see Joint (disambiguation). ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Elbow redirects here. ... For other uses, see Knee (disambiguation). ... The scalp is the anatomical area bordered by the face anteriorly and the neck to the sides and posteriorly. ... A sex organ, or primary sexual characteristic, as narrowly defined, is any of the anatomical parts of the body which are involved in sexual reproduction and constitute the reproductive system in a complex organism; in mammals, these are: Female: Bartholins glands, cervix, clitoris, Fallopian tubes, labia, ovaries, Skenes... A hypothesis (= assumption in ancient Greek) is a proposed explanation for a phenomenon. ... Immune-mediated diseases are conditions which result from abnormal activity of the bodys immune system. ... A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. ...

The disorder is a chronic recurring condition which varies in severity from minor localised patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) - and can be seen as an isolated finding. Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. Ten to fifteen percent of people with psoriasis have psoriatic arthritis. This article is about the medical term. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... For other uses, see Nail. ... Psoriatic arthritis (or Arthropathic psoriasis) is a type of inflammatory arthritis that affects around 20% of people suffering from the chronic skin condition Psoriasis. ... In mathematics, a percentage is a way of expressing a number as a fraction of 100 (per cent meaning per hundred). It is often denoted using the percent sign, %. For example, 45% (read as forty-five percent) is equal to 45 / 100, or 0. ...

The cause of psoriasis is not known, but it is believed to have a genetic component. Several factors are thought to aggravate psoriasis. These include stress, excessive alcohol consumption, and smoking.^[3] Individuals with psoriasis may suffer from depression and loss of self-esteem. As such, quality of life is an important factor in evaluating the severity of the disease. There are many treatments available but because of its chronic recurrent nature psoriasis is a challenge to treat. This article is about the general scientific term. ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... The relationship between alcohol consumption and health has been the subject of formal scientific research since at least 1926, when Dr. Raymond Pearl published his book, Alcohol and Longevity, in which he reported his finding that drinking alcohol in moderation was associated with greater longevity than either abstaining or drinking... The cigarette is the most common method of smoking tobacco. ... On the Threshold of Eternity. ... In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ... Quality of life is the degree of well-being felt by an individual or group of people. ...

History

Psoriasis is probably one of the longest known illnesses of humans and simultaneously one of the most misunderstood. Some scholars believe psoriasis to have been included among the skin conditions called tzaraat in the Bible.^[4] In more recent times psoriasis was frequently described as a variety of leprosy. The Greeks used the term lepra (λεπρα) for scaly skin conditions. They used the term psora to describe itchy skin conditions. It became known as Willan's lepra in the late 18th century when English dermatologists Robert Willan and Thomas Bateman differentiated it from other skin diseases. They assigned names to the condition based on the appearance of lesions. Willan identified two categories: leprosa graecorum and psora leprosa. Tzaraath (tzaraas, tzaraat, tsaraas, tsaraat; Hebrew צרעת) is an affliction mentioned in the Tanach and other Jewish sources, starting in Leviticus 13–Leviticus 14. ... For other uses, see Bible (disambiguation). ... For the malady found in the Hebrew Bible, see Tzaraath. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... Robert Willan (born 12 November 1757 near Sedbergh, Yorkshire; died 7 April 1812, Madeira) is the founder of dermatology as a medical specialty. ...

While it may have been visually, and later semantically, confused with leprosy it was not until 1841 that the condition was finally given the name psoriasis by the Viennese dermatologist Ferdinand von Hebra. The name is derived from the Greek word psora which means to itch.^[5] Semantics (Ancient σημαντικός semantikos significant, from semainein to signify, mean, from sema sign, token), is the study of meaning in communication. ... For the malady found in the Hebrew Bible, see Tzaraath. ... 1841 is a common year starting on Friday (link will take you to calendar). ... For other uses, see Vienna (disambiguation). ... Ferdinand von Hebra Ferdinand Ritter von Hebra was an Austrian physician and dermatologist, b. ...

It was during the 20th century that psoriasis was further differentiated into specific types.

Types of psoriasis

The symptoms of psoriasis can manifest in a variety of forms. Variants include plaque, pustular, guttate and flexural psoriasis. This section describes each type (with ICD-10 code [6]).^[6] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...

Photograph of an arm covered with plaque psoriasis.

Plaque psoriasis (psoriasis vulgaris) (L40.0) is the most common form of psoriasis. It affects 80 to 90% of people with psoriasis. Plaque psoriasis typically appears as raised areas of inflamed skin covered with silvery white scaly skin. These areas are called plaques. Description of the image Plaque psoriasis on an arm Source of image Photograph taken of my own arm with a digital camera, 17th February 2004. ...

Flexural psoriasis (inverse psoriasis) (L40.83-4) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals (between the thigh and groin), the armpits, under an overweight stomach (pannus), and under the breasts (inframammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections. Skin folds are areas of skin where it folds. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in an complex organism; namely: Male: penis (notably the glans penis... The armpit (or axilla) is the area on the human body directly under the area where the arm connects to the shoulder. ... Pannus is a medical term for a hanging flap of skin. ... okay that is all ... Cross section of the breast of an adult, female human. ... For other uses, see Friction (disambiguation). ... SWEAT is an OLN/TSN show hosted by Julie Zwillich that aired in 2003-2004. ... toes infection brown with white markings ...

Guttate psoriasis (L40.4) is characterized by numerous small round (teardrop-shaped) spots (differential diagnosis - pityriasis rosea - oval shape lesion). These numerous spots of psoriasis appear over large areas of the body, such as the trunk, limbs, and scalp. Guttate psoriasis is associated with streptococcal throat infection. The scalp is the anatomical area bordered by the face anteriorly and the neck to the sides and posteriorly. ... Strep throat (or Streptococcal pharyngitis, or Streptococcal Sore Throat) is a form of Group A streptococcal infection that affects the pharynx. ...

Pustular psoriasis (L40.1-3, L40.82) appears as raised bumps that are filled with non-infectious pus (pustules). The skin under and surrounding pustules is red and tender. Pustular psoriasis can be localised, commonly to the hands and feet (palmoplantar pustulosis), or generalised with widespread patches occurring randomly on any part of the body.

Nail psoriasis (L40.86) produces a variety of changes in the appearance of finger and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail. Nail diseases are in a separate category from diseases of the skin. ...

Psoriatic arthritis (L40.5) involves joint and connective tissue inflammation. Psoriatic arthritis can affect any joint but is most common in the joints of the fingers and toes. This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriatic arthritis can also affect the hips, knees and spine (spondylitis). About 10-15% of people who have psoriasis also have psoriatic arthritis. Psoriatic arthritis (or Arthropathic psoriasis) is a type of inflammatory arthritis that affects around 20% of people suffering from the chronic skin condition Psoriasis. ... Connective tissue is one of the four types of tissue in traditional classifications (the others being epithelial, muscle, and nervous tissue. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Dactylytis is a sausage-shaped swelling of the fingers and toes, and can be painful. ... Not to be confused with spondylosis. ...

Erythrodermic psoriasis (L40.85) involves the widespread inflammation and exfoliation of the skin over most of the body surface. It may be accompanied by severe itching, swelling and pain. It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic treatment. This form of psoriasis can be fatal, as the extreme inflammation and exfoliation disrupt the body's ability to regulate temperature and for the skin to perform barrier functions.^[7]

Diagnosis

A diagnosis of psoriasis is usually based on the appearance of the skin. There are no special blood tests or diagnostic procedures for psoriasis. Sometimes a skin biopsy, or scraping, may be needed to rule out other disorders and to confirm the diagnosis. Skin from a biopsy will show clubbed Rete pegs if positive for psoriasis. Another sign of psoriasis is that when the plaques are scraped, one can see pinpoint bleeding from the skin below (Auspitz's sign). In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Auspitzs sign is the appearance of punctate bleeding spots when psoriasis scales are scraped off. ...

Pie chart showing the distribution of severity among people with psoriasis.

Image File history File linksMetadata Psoriasis_severity. ... Image File history File linksMetadata Psoriasis_severity. ...

Severity

Psoriasis is usually graded as mild (affecting less than 3% of the body), moderate (affecting 3-10% of the body) or severe. Several scales exist for measuring the severity of psoriasis. The degree of severity is generally based on the following factors: the proportion of body surface area affected; disease activity (degree of plaque redness, thickness and scaling); response to previous therapies; and the impact of the disease on the person.

The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).^[8] Nevertheless, the PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.^[9]

Effect on the quality of life

Psoriasis has been shown to affect health-related quality of life to an extent similar to the effects of other chronic diseases such as depression, myocardial infarction, hypertension, congestive heart failure or type 2 diabetes. Depending on the severity and location of outbreaks, individuals may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as self-care, walking, and sleep. Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. The frequency of medical care is costly and can interfere with an employment or school schedule. On the Threshold of Eternity. ... Heart attack redirects here. ... For other forms of hypertension, see Hypertension (disambiguation). ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... See diabetes mellitus for further general information on diabetes. ... For other uses, see Walking (disambiguation). ... For other uses, see Sleep (disambiguation). ... Alternate meanings: Hand (disambiguation) A human left hand The hand (med. ... For other uses, see Foot (disambiguation). ... A sport consists of a physical activity or skill carried out with a recreational purpose: for competition, for self-enjoyment, to attain excellence, for the development of a skill, or some combination of these. ...

Individuals with psoriasis may also feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns. Psychological distress can lead to significant depression and social isolation. On the Threshold of Eternity. ... Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ...

Epidemiology

Psoriasis affects both sexes equally and can occur at any age, although it most commonly appears for the first time between the ages of 15 and 25 years. This article or section does not cite its references or sources. ... The effects of ageing on a human face Elderly woman Ageing or aging is the process of systems deterioration with time. ...

The prevalence of psoriasis in Western populations is estimated to be around 2-3%. The prevalence of psoriasis among 7.5 million patients who were registered with a general practitioner in the United Kingdom was 1.5%^[10]. A survey ^[11] conducted by the National Psoriasis Foundation (a US based psoriasis education and advocacy group) found a prevalence of 2.1% among adult Americans. The study found that 35% of people with psoriasis could be classified as having moderate to severe psoriasis. In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... Statistical surveys are used to collect quantitative information about items in a population. ... The National Psoriasis Foundation (NPF) is a non-profit US based psoriasis education and advocacy group. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American... This article is about political advocates. ... This article is about the human developmental stage. ...

Around one-third of people with psoriasis report a family history of the disease, and researchers have identified genetic loci associated with the condition. Studies of monozygotic twins suggest a 70% chance of a twin developing psoriasis if the other twin has psoriasis. The concordance is around 20% for dizygotic twins. These findings suggest both a genetic predisposition and an environmental response in developing psoriasis^[12]. In medicine, a family history consists of information about disorders that a patients direct blood relatives have suffered from. ... Short and long arms Chromosome. ... For other uses, see Twin (disambiguation). ... Concordance as used in genetics means the presence of the same trait in both members of a pair of twins, or in sets of individuals. ... For other uses, see Twin (disambiguation). ...

Onset before age 40 usually indicates a greater genetic susceptibility and a more severe or recurrent course of psoriasis.

Cause

The cause of psoriasis is not fully understood. There are two main hypotheses about the process that occurs in the development of the disease. The first considers psoriasis as primarily a disorder of excessive growth and reproduction of skin cells. The problem is simply seen as a fault of the epidermis and its keratinocytes. The second hypothesis sees the disease as being an immune-mediated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system. T cells (which normally help protect the body against infection) become active, migrate to the dermis and trigger the release of cytokines (tumor necrosis factor-alpha TNFα, in particular) which cause inflammation and the rapid production of skin cells. It is not known what initiates the activation of the T cells. Cross-section of all skin layers Optical coherence tomography tomogram of fingertip, depicting stratum corneum (~500µm thick) with stratum disjunctum on top and stratum lucidum (connection to stratum spinosum) in the middle. ... The keratinocyte is the major cell type of the epidermis, making up about 90% of epidermal cells. ... Immune-mediated diseases are conditions which result from abnormal activity of the bodys immune system. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... T cells are a subset of lymphocytes that play a large role in the immune response. ... The dermis is a layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. ... Cytokines are small protein molecules that are the core of communication between immune system cells, and even between immune system cells and cells belonging to other tissue types. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ...

The immune-mediated model of psoriasis has been supported by the observation that immunosuppressant medications can clear psoriasis plaques. However, the role of the immune system is not fully understood, and it has recently been reported that an animal model of psoriasis can be triggered in mice lacking T cells.^[13] Animal models, however, reveal only a few aspects resembling human psoriasis. Immunosuppression is the medical suppression of the immune system. ... Animal model refers to a non-human animal with a disease that is similar to a human condition. ... Animal model refers to a non-human animal with a disease that is similar to a human condition. ...

Psoriasis is a fairly idiosyncratic disease. The majority of people's experience of psoriasis is one in which it may worsen or improve for no apparent reason. Studies of the factors associated with psoriasis tend to be based on small (usually hospital based) samples of individuals. These studies tend to suffer from representative issues, and an inability to tease out causal associations in the face of other (possibly unknown) intervening factors. Conflicting findings are often reported. Nevertheless, the first outbreak is sometimes reported following stress (physical and mental), skin injury, and streptococcal infection. Conditions that have been reported as accompanying a worsening of the disease include infections, stress, and changes in season and climate. Certain medicines, including lithium salt and beta blockers, have been reported to trigger or aggravate the disease. Excessive alcohol consumption, smoking and obesity may exacerbate psoriasis or make the management of the condition difficult.^[14][15] This page is a candidate to be moved to Wiktionary. ... A causal system is a system that depends only on the current and previous inputs. ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... Species S. pneumoniae S. pyogenes S. viridans Streptococcus is a genus of spherical, Gram-positive bacteria of the phylum Firmicutes. ... Lithium salts are chemical salts of lithium used primarily in the treatment of bipolar disorder as mood stabilizing drugs. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ...

Individuals suffering from the advanced effects of the Human immunodeficiency virus, or HIV, often exhibit psoriasis.^[16] This presents a paradox to researchers as traditional therapies that reduce T-cell counts generally cause psoriasis to improve. Yet, as CD4-T-cell counts decrease with the progression of HIV, psoriasis worsens.^[17] In addition, HIV is typically characterized by a strong Th2 cytokine profile, whereas psoriasis vulgaris is characterized by a strong Th1 secretion pattern.^[18] It's hypothesized that the diminished CD4-T-Cell presence causes an over-activation of CD8-T-Cells, which are responsible for the exacerbation of psoriasis in HIV positive patients. It is important to remember that most individuals with psoriasis are otherwise healthy and the presence of HIV accounts for less than 1% of cases. The prevalence of psoriasis in the HIV positive population ranges from 1 to 6 percent, which is about 3 times higher than the normal population.^[19] Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... T cells belong to a group of white blood cells known as lymphocytes and play a central role in cell-mediated immunity. ... Antigen presentation stimulates T cells to become either cytotoxic CD8+ cells or helper CD4+ cells. ... Cytokines are a category of less-widely-known signalling proteins and glycoproteins that, like hormones and neurotransmitters, are used extensively in cellular communication. ... Antigen presentation stimulates T cells to become either cytotoxic CD8+ cells or helper CD4+ cells. ...

Schematic of psoriasis treatment ladder

Treatment

There can be substantial variation between individuals in the effectiveness of specific psoriasis treatments. Because of this, dermatologists often use a trial-and-error approach to finding the most appropriate treatment for their patient. The decision to employ a particular treatment is based on the type of psoriasis, its location, extent and severity. The patient’s age, sex, quality of life, comorbidities, and attitude toward risks associated with the treatment are also taken into consideration. Dermatology (Greek δερμα, skin and λόγος, word, science) is a branch of medicine dealing with the skin and its appendages (hair, sweat glands, etc). ... In medicine and in psychiatry, comorbidity refers to: The presence of one or more disorders (or diseases) in addition to a primary disease or disorder. ...

Medications with the least potential for adverse reactions are preferentially employed. If the treatment goal is not achieved then therapies with greater potential toxicity may be used. Medications with significant toxicity are reserved for severe unresponsive psoriasis. This is called the psoriasis treatment ladder.^[20] As a first step, medicated ointments or creams, called topical treatments, are applied to the skin. If topical treatment fails to achieve the desired goal then the next step would be to expose the skin to ultraviolet (UV) radiation. This type of treatment is called phototherapy. The third step involves the use of medications which are taken internally by pill or injection. This approach is called systemic treatment. // Toxic and Intoxicated redirect here – toxic has other uses, which can be found at Toxicity (disambiguation); for the state of being intoxicated by alcohol see Drunkenness. ... An ointment is a viscous semisolid preparation used topically on a variety of body surfaces. ... For other uses, see Ultraviolet (disambiguation). ... Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ... An injection is a method of putting liquid into the body with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body. ...

Over time, psoriasis can become resistant to a specific therapy. Treatments may be periodically changed to prevent resistance developing (tachyphylaxis) and to reduce the chance of adverse reactions occurring. This is called treatment rotation. This article or section does not adequately cite its references or sources. ...

Topical treatment

Bath solutions and moisturizers help soothe affected skin and reduce the dryness which accompanies the build-up of skin on psoriatic plaques. Medicated creams and ointments applied directly to psoriatic plaques can help reduce inflammation, remove built-up scale, reduce skin turn over, and clear affected skin of plaques. Ointment and creams containing coal tar, dithranol (anthralin), corticosteroids like desoximetasone (Topicort), vitamin D₃ analogues (for example, calcipotriol), and retinoids are routinely used. Argan oil has also been used with some promising results.^[21] The mechanism of action of each is probably different but they all help to normalise skin cell production and reduce inflammation. Activated vitamin D and its analogues are highly effective inhibitors of skin cell proliferation. Moisturizers are a complex mixture of chemical agents specially designed to make the external layers of the skin (epidermis) softer and more pliable, by increasing its hydration (water content). ... Coal tar is the liquid by-product of the distillation of coal to make coke. ... Dithranol (INN) or Anthralin (USAN and former BAN) is a Hydroxyanthrone, anthracene derivative, medicine applied to the skin of people with psoriasis. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... Calcipotriol (INN) (Calcipotriene (USAN)) is a topical medication used for the treatment of psoriasis. ... First- and second-generation retinoid compounds The retinoids are a class of chemical compounds that are related chemically to vitamin A. Retinoids are used in medicine, primarily due to the way they regulate epithelial cell growth. ... Argan oil is an oil produced from the fruits of the Argan (Argania spinosa) a species of tree endemic to the calcareous semi-desert of southwestern Morocco. ... Wikipedia does not yet have an article with this exact name. ...

The disadvantages of topical agents are variably that they can often irritate normal skin, can be time consuming and awkward to apply, cannot be used for long periods, can stain clothing or have a strong odour. As a result, it is sometimes difficult for people to maintain the regular application of these medications. Abrupt withdrawal of some topical agents, particularly corticosteroids, can cause an aggressive recurrence of the condition. This is known as a rebound of the condition. The tone or style of this article or section may not be appropriate for Wikipedia. ... For other uses, see Stain (disambiguation). ... A baby wearing many items of winter clothing: headband, cap, fur-lined coat, shawl and sweater. ... Aroma redirects here. ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...

Some topical agents are used in conjunction with other therapies, especially photo therapy.

Phototherapy

It has long been recognized that daily, short, non-burning exposure to sunlight helped to clear or improve psoriasis. Niels Finsen was the first physician to investigate the therapeutic effects of sunlight scientifically and to use sunlight in clinical practice. This became known as phototherapy. Prism splitting light High Resolution Solar Spectrum Sunlight in the broad sense is the total spectrum of the electromagnetic radiation given off by the Sun. ... Niels Ryberg Finsen (December 15, 1860 – September 24, 1904) was a Icelandic/Faroese/Danish physician and scientist. ... For other uses, see Doctor. ... Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ...

Sunlight contains many different wavelengths of light. It was during the early part of the 20th century that it was recognised that for psoriasis the therapeutic property of sunlight was due to the wavelengths classified as ultraviolet (UV) light. Prism splitting light High Resolution Solar Spectrum Sunlight in the broad sense is the total spectrum of the electromagnetic radiation given off by the Sun. ... For other uses, see Wavelength (disambiguation). ... For other uses, see Ultraviolet (disambiguation). ...

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. Exposure to UVB several times per week, over several weeks can help people attain a remission from psoriasis. Cross-section of all skin layers Optical coherence tomography tomogram of fingertip, depicting stratum corneum (~500µm thick) with stratum disjunctum on top and stratum lucidum (connection to stratum spinosum) in the middle. ...

Ultraviolet light treatment is frequently combined with topical (coal tar, calcipotriol) or systemic treatment (retinoids) as there is a synergy in their combination. The Ingram regime, involves UVB and the application of anthralin paste. The Goeckerman regime combines coal tar ointment with UVB. Synergy (from the Greek synergos, συνεργός meaning working together, circa 1660) refers to the phenomenon in which two or more discrete influences or agents acting together create an effect greater than that predicted by knowing only the separate effects of the individual agents. ... Anthralin is a medicine applied to the skin of people with psoriasis. ...

Photochemotherapy

Psoralen and ultraviolet A phototherapy (PUVA) combines the oral or topical administration of psoralen with exposure to ultraviolet A (UVA) light. Precisely how PUVA works is not known. The mechanism of action probably involves activation of psoralen by UVA light which inhibits the abnormally rapid production of the cells in psoriatic skin. There are multiple mechanisms of action associated with PUVA, including effects on the skin immune system. Psoralen (also called psoralene) is the parent compound in a family of natural products known as furocoumarins. ... PUVA is a Psoralen + UVA treatment. ... Wikipedia does not yet have an article with this exact name. ...

PUVA is associated with nausea, headache, fatigue, burning, and itching. Long-term treatment is associated with squamous-cell and melanoma skin cancers. For other uses, see Nausea (disambiguation). ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... Biopsy of a highly differentiated squamous cell carcinoma of the mouth. ... Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye (see uveal melanoma). ... Skin cancer is a malignant growth on the skin which can have many causes. ...

Systemic treatment

Psoriasis which is resistant to topical treatment and phototherapy is treated by medications that are taken internally by pill or injection. This is called systemic treatment. Patients undergoing systemic treatment are required to have regular blood and liver function tests because of the toxicity of the medication. Pregnancy must be avoided for the majority of these treatments. Most people experience a recurrence of psoriasis after systemic treatment is discontinued. In medicine, a topical medication is applied to body surfaces such as the skin or mucous membranes such as the vagina, nasopharynx, or the eye. ... Bright light therapy is a common treatment for seasonal affective disorder. ... This article does not cite any references or sources. ... Look up Pill in Wiktionary, the free dictionary. ... An injection is a method of putting liquid into the body with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Liver function tests (LFTs or LFs), which include liver enzymes, are groups of clinical biochemistry laboratory blood assays designed to give information about the state of a patients liver. ... // Toxic and Intoxicated redirect here – toxic has other uses, which can be found at Toxicity (disambiguation); for the state of being intoxicated by alcohol see Drunkenness. ... This article does not cite any references or sources. ... This article is about pregnancy in female humans. ...

The three main traditional systemic treatments are methotrexate, cyclosporine and retinoids. Methotrexate and cyclosporine are immunosupressant drugs; retinoids are synthetic forms of vitamin A. Other additional drugs, not specifically licensed for psoriasis, have been found to be effective. These include the antimetabolite tioguanine, the cytotoxic agent hydroxyurea, sulfasalazine, the immunosupressants mycophenolate mofetil, azathioprine and oral tacrolimus. These have all been used effectively to treat psoriasis when other treatments have failed. Although not licensed in many other countries fumaric acid esters have also been used to treat severe psoriasis in Germany for over 20 years. Amethopterin redirects here. ... Cyclosporine (IPA: ), ciclosporin (INN), or cyclosporin (former BAN), is an immunosuppressant drug. ... The Retinoids are a class of chemical compounds that are related chemically to vitamin A. Retinoids are used in medicine, primarily due to the way they regulate epithelial cell growth. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... The structure of retinol, the most common dietary form of vitamin A Vitamin A is an essential human nutrient. ... Effectiveness means the capability of producing an effect. ... An antimetabolite is a chemical with a similar structure to a substance (a metabolite) required for normal biochemical reactions, yet different enough to interfere with the normal functions of cells, including cell division. ... Tioguanine (INN), formerly Thioguanine (BAN), is a drug that is used in the treatment of cancer. ... Cytotoxicity is the quality of being poisonous to cells. ... Hydroxyurea chemical structure Hydroxyurea or hydroxycarbamide (rINN), (brand names include Hydrea®) is an antineoplastic drug used in hematological malignancies. ... Sulfasalazine is a sulfa drug, a derivative of Mesalazine (5-aminosalicylic acid abbreviated as 5-ASA), used primarily as an anti-inflammatory agent in the treatment of inflammatory bowel disease as well as for rheumatoid arthritis. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... Mycophenolate mofetil (MMF, trade name Cellcept®) is an immunosuppresant drug used to prevent rejection in organ transplantation. ... Azathioprine is a chemotherapy drug, now rarely used for chemotherapy but more for immunosuppression in organ transplantation, autoimmune disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohns disease. ... Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after allogenic organ transplant to reduce the activity of the patients immune system and so the risk of organ rejection. ... Effectiveness means the capability of producing an effect. ... Fumaric acid (IUPAC systematic name: 2-butenedioic acid), also called allomaleic acid, boletic acid or lichenic acid, is a colorless crystalline flammable carboxylic acid based on butene and molecular formula C4H4O4. ...

Biologics are manufactured proteins that interrupt the immune process involved in psoriasis. Unlike generalised immunosuppressant therapies such as methotrexate, biologics focus on specific aspects of the immune function leading to psoriasis. These drugs (interleukin antagonists) are relatively new, and their long-term impact on immune function is unknown. They are very expensive and only suitable for very few patients with psoriasis. Ustekinumab (IL-12 and IL-23 blocker) shows hopeful results for psoriasis therapy. Biologics or biologic therapies are a new class of drugs produced through genetic manipulation. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... Interleukin 12 (IL-12) is an interleukin that are naturally produced by macrophages and human B-lymphoblastoid cells (NC-37)in response to antigenic stimulation. ... Interleukin-23 (IL-23) is a heterodimeric cytokine consisting of two subunits, one called p40, which is shared with another cytokine, IL-12, and another called p19 (the IL-23 alpha subunit). ...

A new natural systemic option, XP-828L, for mild to moderate psoriasis relief has been developed by a Canadian life science and technology company. This oral product with clinically proven efficacy and safety is extracted through a patented process from whey and has immuno-modulatory effects.^[22][23][24]

Alternative therapy

Milk thistle is believed to help prevent psoriasis outbreaks by encouraging proper liver function. The liver neutralizes certain toxins associated with psoriasis.^[25] Species Silybum eburneum Silybum marianum Silybum × gonzaloi This article is about the true milk thistles. ...

Antibiotics are not indicated in routine treatment of psoriasis. However, antibiotics may be employed when an infection, such as that caused by the bacteria Streptococcus, triggers an outbreak of psoriasis, as in certain cases of guttate psoriasis.^{[citation needed]} An antibiotic is a drug that kills or slows the growth of bacteria. ... Species S. agalactiae S. bovis S. mutans S. pneumoniae S. pyogenes S. salivarius S. sanguinis S. suis Streptococcus viridans Streptococcus uberis etc. ...

Climatotherapy involves the notion that some diseases can be successfully treated by living in a particular climate. Several psoriasis clinics are located throughout the world based on this idea. The Dead Sea is one of the most popular locations for this type of treatment. The Dead Sea (Hebrew: ‎, , Sea of Salt; Arabic: , , Dead Sea) is a salt lake between the West Bank and Israel to the west, and Jordan to the east. ...

In Turkey & in Croatia (Altermedica), doctor fish which live in the outdoor pools of spas, are encouraged to feed on the psoriatic skin of people with psoriasis. The fish only consume the affected areas of the skin. The outdoor location of the spa may also have a beneficial effect. This treatment can provide temporary relief of symptoms. A revisit to the spas every few months is often required. Best known is the spa “Kangal Thermal Springs”, near the Turkish village of Kavak. According to the testimony of numerous psoriasis patients, the fish lead to a significant relief. This spa is located south of the historic silk road in Anatolia. The next big city is Sivas. Treatment in this hot spring has been examined until now in two small clinical trials, with positive results.^{[26] [27]} Binomial name Heckel, 1846 The term doctor fish is the name given to two species of fish (Garra rufa, discussed here, and Cyprinion macrostomus). ... For other uses, see Silk Road (disambiguation). ... This article is about two nested areas of Turkey, a plateau region within a peninsula. ... Sivas is the provincial capital of Sivas Province in Turkey. ...

Some people^[who?] subscribe to the view that psoriasis can be effectively managed through a healthy lifestyle. This view is based on anecdotal evidence, and has not been subjected to formal scientific evaluation. Nevertheless, some people report that minimizing stress and consuming a healthy diet, combined with rest, sunshine and swimming in saltwater keep lesions to a minimum. This type of "lifestyle" treatment is suggested as a long-term management strategy, rather than an initial treatment of severe psoriasis. An anecdote is a short tale narrating an interesting or amusing biographical incident. ...

A number of patients have reported significant improvements from sun and sea water: unfortunately, salt alone does not have any effect. Sea water contains so many minerals and different life forms (thousands of species of bacteria alone^[28]) that it will be hard to determine which of these is causing the observed effects. Interestingly, people in the tropics differentiate between "live" and "dead" sea water: "live" sea water is water that has never been covered.^[29]

Some psoriasis patients use herbology as a holistic approach that aims to treat the underlying causes of psoriasis. Some alternative therapies consider Oil of Oregano to be a powerful herbal method of treatment. Herbology is the art of combining medicinal herbs. ... Binomial name Origanum vulgare L. Oregano or Pot Marjoram (Origanum vulgare) is a species of Origanum, native to Europe, the Mediterranean region and southern and central Asia. ...

A psychological symptom management programme has been reported as being a helpful adjunct to traditional therapies in the management of psoriasis.^[30]

Zinc oxide (ZnO) is used for several skin afflictions and according to some patients also provides relief.^{[citation needed]}

Historical treatment

The history of psoriasis is littered with treatments of dubious effectiveness and high toxicity. These treatments received brief popularity at particular time periods or within certain geographical regions. The application of cat faeces to red lesions on the skin, for example, was one of the earliest topical treatments employed in ancient Egypt. Onions, sea salt and urine, goose oil and semen, wasp droppings in sycamore milk, and soup made from vipers have all been reported as being ancient treatments. Binomial name Felis catus Linnaeus, 1758 Synonyms Felis lybica invalid junior synonym The cat (or domestic cat, house cat) is a small carnivorous mammal. ... Rabbit feces are usually 0. ... This article is about the urine of animals generally. ... Horse semen being collected for breeding purposes. ... Sycamore is a name applied at various times and places to three very different types of trees, but with somewhat similar leaf forms. ... Synonyms Viperae - Laurenti, 1768 Viperini - Oppel, 1811 Viperidae - Gray, 1825[1] The Viperidae are a family of venomous snakes commonly referred to as vipers, although the term viperids is more specific and distinguishes them from the viperines (subfamily Viperinae). ...

In the more recent past Fowler's solution, which contains a poisonous and carcinogenic arsenic compound, was used by dermatologists as a treatment for psoriasis during the 18th and 19th centuries. Grenz rays (also called ultrasoft X-rays or Bucky rays) was a popular treatment of psoriasis during the middle of the 20th century. This type of therapy was superseded by ultraviolet therapy. Fowlers solution is a remedy (or a tonic) that was discovered in 1786 and prescribed for a range of ailments for over 150 years. ... This article is about the dangerous substance. ... In pathology, a carcinogen is any substance or agent that promotes cancer. ... General Name, Symbol, Number arsenic, As, 33 Chemical series metalloids Group, Period, Block 15, 4, p Appearance metallic gray Standard atomic weight 74. ... Grenz Rays are a type of ultrasoft radiation waves used in the treatment of skin conditions such as dermatitis, psoriasis and hand eczma. ...

Undecylenic acid was investigated and used for psoriasis some 40 years ago.(cir. 1950~)^[31] Undecylenic Acid is an organic fatty acid derived from natural Castor oil (ricinoleic acid). ...

All these treatments have fallen out of favour.

Sulphur was fashionable as a treatment for psoriasis in the Victorian and Edwardian eras. It has recently re-gained some credibility as a safe alternative to steroids and coal tar.

Future drug development

Historically, agents used to treat psoriasis were discovered by experimentation or by accident. In contrast, current novel therapeutic agents are designed from a better understanding of the immune processes involved in psoriasis and by the specific targeting of molecular mediators. Examples can be seen in the use of biologics which target T cells and TNF inhibitors.

It has been suggested that cannabis might treat psoriasis, due to the anti-inflammatory properties of its cannabinoids, and the regulatory effects of THC on the immune system.^[32] The adverse effects of cannabis might be overcome by use of more specific cannabinoid receptor medications,^[33] to inhibit keratinocyte proliferation.^[34] Cannabis, also known as marijuana[1] or ganja (Hindi: गांजा),[2] is a psychoactive product of the plant Cannabis sativa. ... Cannabinoids are a group of terpenophenolic compounds present in Cannabis (Cannabis sativa L). ... The acronym THC has several possible meanings: Teens Hate Chains, a Japanese singing group Tetrahydrocannabinol, the main active ingredient in Cannabis Tetrahydrocurcuminoids, extracted from Turmeric as an active ingredient in cosmetics Texas Historical Commission Therapeutic Humane Cannabis Act Thermohaline circulation The History Channel Terminal Handling Charges This page concerning a...

Future innovation should see the creation of additional drugs that refine the targeting of immune-mediators further.^[35]

Research into antisense oligonucleotides carries the potential to provide novel therapeutic strategies for treating psoriasis.^[36] Oligonucleotides are short sequences of nucleotides (RNA or DNA), typically with twenty or fewer bases. ...

ABT-874 is a human anti-IL-12 monoclonal antibody being developed by Abbott Laboratories in conjunction with Cambridge Antibody Technology for the treatment of multiple autoimmune diseases including psoriasis. Phase II trials have been completed and showed promising results.^[37] Abbott was planning to initiate Phase III trials in 2007.^[38] Interleukin 12 (IL-12) is an interleukin that are naturally produced by macrophages and human B-lymphoblastoid cells (NC-37)in response to antigenic stimulation. ... Monoclonal antibodies (mAb) are antibodies that are identical because they were produced by one type of immune cell, all clones of a single parent cell. ... Abbott Laboratories (NYSE: ABT) is a diversified pharmaceuticals and health care company. ...

In 2004, Tas and Avci ^[39] demonstrated cyclopamine’s clinical potential for the treatment of psoriasis and basal cell carcinoma in two preliminary proof of concept studies. By treating 31 psoriatic lesions in 7 patients, these authors asserted that topical cyclopamine was more effective in the clinical and histological clearance of guttate and plaque psoriasis than the topical steroid clobetasol-17 propionate.Furthermore, they demonstrated that concurrent application of cylopamine and clobetasol-17 propionate accelerated regression and clearance of selected lesions greater than cyclopamine alone with clearance times as early as 48 hours.They assert that cyclopamine inhibits the abnormal proliferation of epithelial cells, induces terminal differentiation, and is associated with the decreased presence of inflammatory cells, including CD41 lymphocytes.

On August 27, 2006, scientists led by Jeung-Hoon Lee created in the laboratory synthetic lipids called pseudoceramides which are involved in skin cell growth and could be used in treating skin diseases such as atopic dermatitis, a form of eczema characterized by red, flaky and very itchy skin; psoriasis, and glucocorticoid-induced epidermal atrophy, in which the skin shrinks due to skin cell loss.^[40] For a List of scientists, see: List of anthropologists List of astronomers List of biologists List of chemists List of computer scientists List of economists List of engineers List of geologists List of inventors List of mathematicians List of meteorologists List of physicists Scientist pairs List of scientist pairs See... This article does not cite any references or sources. ... Skin cells have most common organelles in them. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... Eczema (from Greek έκζεμα) is a form of dermatitis, or inflammation of the upper layers of the skin. ...

Prognosis

Psoriasis is a lifelong condition.^[41] There is currently no cure but various treatments can help to control the symptoms. Many of the most effective agents used to treat severe psoriasis carry an increased risk of significant morbidity including skin cancers, lymphoma and liver disease. However, the majority of people's experience of psoriasis is that of minor localized patches, particularly on the elbows and knees, which can be treated with topical medication. Psoriasis does get worse over time but it is not possible to predict who will go on to develop extensive psoriasis or those in whom the disease may appear to vanish. Individuals will often experience flares and remissions throughout their lives. Controlling the signs and symptoms typically requires lifelong therapy. Skin cancer is a malignant growth on the skin which can have many causes. ... This article is about lymphoma in humans. ...

According to one study,^[42] psoriasis is linked to 2.5-fold increased risk for non melanoma skin cancer in men and women, with no preponderance of any specific histologic subtype of cancer. This, however could be linked to antipsoriatic treatment.

1964 Tegrin advertisement

Image File history File links Download high-resolution version (288x721, 53 KB) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as advertising material or a promotional photo in a press kit. ... Image File history File links Download high-resolution version (288x721, 53 KB) This is a copyrighted image that has been released by a company or organization to promote their work or product in the media, such as advertising material or a promotional photo in a press kit. ...

"The heartbreak of psoriasis"

The phrase "the heartbreak of psoriasis" is often used both seriously and ironically to describe the emotional impact of the disease. It may include both the effect of having a chronic uncomfortable disorder and the social effects of being self conscious of one's appearance. The term can be found in various advertisements for topical and other treatments; conversely, it has been used to mock the tendency of advertisers to exaggerate (or even fabricate) aspects of a malady for financial gain. While many products today use the phrase in their advertising, it originated in a 1960s advertising campaign for Tegrin, a coal tar-based ointment. Ironic redirects here. ... Coal tar is the liquid by-product of the distillation of coal to make coke. ...

Notable Persons With Psoriasis

• Jason Donovan - Australian actor & singer.

• Robert I of Scotland, King of Scots,usually known in modern English as Robert the Bruce.

• CariDee English - American model and America's Next Top Model, Cycle 7 winner.

• Paul John Ferris - a Scottish businessman, author and former gangster.

• Mark Gastineau - American football player, New York Jets, 1979 to 1988.

• Tom Waits - American singer-songwriter, composer, and actor

• Abimael Guzmán - Leader of the Shining Path ^[43]. Guzmán was captured after Peruvian counter-terrorist agents found Psoriasis treating cream amongst the rubbish coming out of his hideout ^[43].

• William Halsey, Jr. - Admiral, U.S. Navy and Commander of the U.S. Third Fleet during WWII.

• Shawn Lane - musician, suffered from Psoriasis and Psoriatic Arthritis from the age of 13.

• Jerry Mathers - American Actor (Leave it to Beaver, Beav).

• Dennis Potter - English playwright (see his work The Singing Detective).

• Joseph Stalin - General Secretary of the Communist Party, Soviet Union, 1922 - 1953.

• Kenneth Starr - American lawyer, submitted to Congress the Starr Report, which led to former US President Bill Clinton's impeachment charges.

• John Updike - American novelist.

• Eli Roth - American director (see his work Cabin Fever).

• Alan Carr - British TV host and comedian.

• Benjamin Franklin - Founding father of the US

• Alek Wek - Sudanese supermodel

Jason Sean Donovan (born 1 June 1968, Malvern, Melbourne) is an Australian actor and singer. ... Robert I, King of Scots (11 July 1274 – 7 June 1329) usually known in modern English as Robert the Bruce (Mediaeval Gaelic:Roibert a Briuis; modern Scottish Gaelic: Raibeart Bruis; Norman French: Robert de Brus or Robert de Bruys; ) was King of the Scots from 1306 until his death. ... CariDee English (born May 22, 1985[2] in Fargo, North Dakota) is an American fashion model of Norwegian ancestry. ... To meet Wikipedias quality standards, this article may require cleanup. ... For the film composer, see Paul Ferris. ... Marcus Dell Gastineau (born November 20, 1956) is a former American football player who was a leading defensive end for the New York Jets from 1979 to 1988. ... Thomas Alan Waits (born December 7, 1949) is an American singer-songwriter, composer, and actor. ... Guzmán as a prisoner Manuel Rubén Abimael Guzmán Reynoso, also known by his nom de guerre Presidente Gonzalo (English: President Gonzalo), a former professor of philosophy, was the leader of the Maoist insurgency often referred coloquially to as Shining Path (Sendero Luminoso in Spanish). ... The Communist Party of Peru (Spanish: Partido Comunista del Perú), more commonly known as the Shining Path (Sendero Luminoso), is a Maoist guerrilla organization in Peru that launched the internal conflict in Peru in 1980. ... William Frederick Bull Halsey, Jr. ... Shawn Lane (March 21, 1963 – September 26, 2003) was an American musician. ... Jerry Mathers (born June 2, 1948 in Sioux City, Iowa) is an American television, film and stage actor. ... For other uses, see Leave It to Beaver (disambiguation). ... Liber Amoris Dennis Christopher George Potter (17 May 1935—7 June 1994) was a controversial British dramatist who is best known for several widely acclaimed television dramas which mixed fantasy and reality, the personal and the social. ... This article is about the television miniseries. ... Josef Vissarionovich Dzhugashvili (Georgian: , Ioseb Besarionis Dze Jughashvili; Russian: , Iosif Vissarionovich Dzhugashvili) (December 18 [O.S. December 6] 1878[1] – March 5, 1953), better known by his adopted name, Joseph Stalin (alternatively transliterated Josef Stalin), was General Secretary of the Communist Party of the Soviet Unions Central Committee from... Kenneth Winston Starr Kenneth Winston Starr (born July 21, 1946) is an American lawyer and former judge who was appointed to the Office of the Independent Counsel to investigate the death of the deputy White House counsel Vince Foster and the Whitewater land transactions by President Bill Clinton. ... William Jefferson Bill Clinton (born William Jefferson Blythe III[1] on August 19, 1946) was the 42nd President of the United States, serving from 1993 to 2001. ... John Hoyer Updike (born March 18, 1932 in Shillington, Pennsylvania) is an American novelist, poet, short story writer and literary critic. ... Eli Roth (born April 18, 1972) is an American film director, producer, writer and actor. ... This article is about the American horror film. ... For the film producer and manager with a similar name, see Allan Carr. ... This article is about the American political figure. ... This article does not cite any references or sources. ...

References

Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 209th day of the year (210th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 347th day of the year (348th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 203rd day of the year (204th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Common Era (or Anno Domini), in accordance with the Gregorian calendar. ... is the 4th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 203rd day of the year (204th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

Wikimedia Commons has media related to:

Psoriasis

Research and non-commercial

• "Questions and Answers about Psoriasis" at National Institute of Arthritis and Musculoskeletal and Skin Diseases
• Psoriasis at National Institute of Arthritis and Musculoskeletal and Skin Diseases
• Psoriasis at Mayo Clinic
• National Psoriasis Foundation Homepage
• Psoriasis Cure Now Homepage
• Scalp Psoriasis
• Psoriasis Help Homepage
• The Psoriasis Association
• DermAtlas 7
• Psoriasis in Literature
• Ichthyotherapy as Alternative Treatment for Patients with Psoriasis: A Pilot Study