Psoriasis represents chronic inflammatory skin condition with complex pathophysiology and significant genetic background. This disease is characterized by erythematous, scaling lesions that exhibit variable patterns and body distribution, as well as different clinical phenotypes. Psoriasis can singifincatly influence the quality of life and usually requires lifetime control.
Although hippocrates described scaling diseases of the skin under heading 'lopoi', the first clinical description of psoriasis is attributed to Aurelius Celsus who mentioned this disease in his work De re medica. Still, the term 'psoriasis' was first used by a well-known Greek Galen, who derived it from the Greek word 'psora' which means itch.
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They are covered with brittle, dry, silvery or greyish white, loosely adherent scales. Occasionally a white blanching ring can be seen around psoriatic lesions, which is also known as Woronoff's ring. The most commonly affected locations are elbows, knees, umbilicus, scalp, and lumbar area.
Chronic plaque psoriasis represenst the main type of psoriasis, and is found in approximately 90% of cases. Other characteristic forms comprise erythrodermic psoriasis, guttate psoriasis, palmoplantar psoriasis, inverse psoriasis, and both localized and generalized pustular psoriasis. Psoriatic arthritis is a special type of arthritis associated with psoriatic skin lesions that involves peripheral and sacroiliac joints, the axial skeleton, entheses and nails.
Two phenomena are described which are highly specific for psoriasis. A removal of scales leads to pinpoint hemorrhages throughout the lesions, which is known as Auspitz sign and corresponds to damage of dilated vessels in the superificial dermis. On the other hand, Koebner phenomenon represents the development of skin lesions in areas of trauma.
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