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Psoriasis på hænderne kan være med til at begrænse dig i hverdagen både fritid og på arbejdet. Derudover ser man ofte at personer med psoriasis på hænderne ikke deltager i nogen former for fysisk aktivitet, hvilket i nogle tilfælde medfører overvægt.

Sværhedsgraden af psoriasis måles efter både de fysiske og psykiske konsekvenser. Derudover anses det for at være svær psoriasis, hvis mere end 10% af kroppen er ramt, moderat psoriasis hvis 3-10% af kroppen er ramt og mild psoriasis hvis 2% er ramt.

Mange førende eksperter mener, at personer med psoriasis på hænder og fødder skal behandles anderledes end personer med mere generaliserende psoriasis. Det skyldes udelukkende, at personer med psoriasis på hænderne ofte er så påvirket i deres sociale, private og arbejdsliv, at de har svært ved at fungere optimalt. Hudlidelsen svækker simpelthen denne gruppe til at udføre funktioner i dagligdagen, som er helt normale for mange andre.

Få effektive og nemme råd til at bekæmpe psoriasis - direkte i din indbakke.

Parapsoriasis describes a group of cutaneous diseases that can be characterized by scaly patches or slightly elevated papules and/or plaques dispersed on the trunk or proximal extremities that have a resemblance to psoriasis—hence the nomenclature. However, this description includes several inflammatory cutaneous diseases that are unrelated with respect to pathogenesis, histopathology, and response to treatment. Because of the variation in clinical presentation and a lack of a specific diagnostic finding on histopathology, a uniformly accepted definition of parapsoriasis remains lacking.

In 1902, Brocq initially described 3 major entities that fit the description:

Pityriasis lichenoides variants describe scaly dermatoses with necrotic papules that are clinically and histologically different from parapsoriasis. These diseases generally are benign and undergo spontaneous resolution but, at times, may have a protracted course (see Pityriasis Lichenoides for further discussion).

Current terminology of parapsoriasis refers to 2 disease processes that are caused by T-cell–predominant infiltrates in the skin. These disease processes are large plaque parapsoriasis and small plaque parapsoriasis.

As the nomenclature and description of the disease spectrum under the descriptive term parapsoriasis evolved, the primary focus has been on the distinction of whether the disorder progresses to mycosis fungoides (MF) or cutaneous T-cell lymphoma (CTCL). Small plaque parapsoriasis is a benign disorder that rarely if ever progresses. Large plaque parapsoriasis is more ominous in that approximately 10% of patients progress to MF/CTCL. [1] Controversy exists currently in the classification of large plaque parapsoriasis because some believe it is equivalent to the earliest stage CTCL, the patch stage. [2, 3, 4]

The duration of parapsoriasis can be variable. Small plaque disease lasts several months to years and can spontaneously resolve. Large plaque disease is chronic, and treatment is recommended because it may prevent progression to CTCL.

El-Darouti et al reported on a 7-year study of a hypopigmented disorder that the researchers believe should be classified as a new variant of parapsoriasis en plaque. [5]

No clear etiology for small plaque or large plaque parapsoriasis is known, and no specific association has been made with contact exposure or infections.

For more information, see the topic Psoriasis.

The initiating cause of parapsoriasis is unknown, but the diseases likely represent different stages in a continuum of lymphoproliferative disorders from chronic dermatitis to frank malignancy of cutaneous T-cell lymphoma (CTCL).

Small plaque parapsoriasis likely is a reactive process of predominantly CD4 + T cells. Genotypic pattern observed in small plaque parapsoriasis is similar to that observed in chronic dermatitis, and the pattern of clonality of T cells is consistent with the response of a specific subset of T cells that have been stimulated by an antigen. Multiple dominant clones can be detected by polymerase chain reaction (PCR) of T-cell receptor gene usage, which supports a reactive process. Lymphocytes do not show histologic atypia to suggest malignant transformation. Southern blot analysis of T-cell receptor genes from parapsoriasis does not identify a dominant clone of T cells.

Some physicians believe that small plaque parapsoriasis is an abortive T-cell lymphoma; however, no clear distinguishing evidence, such as genetic changes (eg, TP53 mutations) observed in other malignancies, exists to support this contention. [6] Nevertheless, a hint to the verity of this hypothesis is the recent identification of increased telomerase activity in T cells from CTCL at low-grade stages, high-grade lymphoma, and parapsoriasis, which is activity not exhibited in normal T cells. A better understanding is likely to develop from further molecular characterization. [7]

Large plaque parapsoriasis is a chronic inflammatory disorder, and the pathophysiology has been speculated to be long-term antigen stimulation. This disorder is associated with a dominant T-cell clone, one that may represent up to 50% of the T-cell infiltrate. If the histologic appearance is benign, without atypical lymphocytes, classification of large plaque parapsoriasis is made. If atypical lymphocytes are present, many would classify such patients as having patch stage CTCL.

In one study, human herpesvirus type 8 was detected in up to 87% of skin lesions of large plaque parapsoriasis. This is the first association of a specific infectious agent with large plaque parapsoriasis, and the significance is unclear. Further studies are important to determine the significance of this finding. [8]

The close relationship between large plaque parapsoriasis and mycosis fungoides is highlighted by the detection of TOX expression, a new marker that has been described to be frequently detected in the abnormal T cells in mycosis fungoides. In one study, large plaque parapsoriasis has expression of TOX similar to that of mycosis fungoides. [9]

Reviewed by:
Dr Hannah Gronow, 17 Jan 2018

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Psoriasis article more useful, or one of our other health articles.

Synonyms: psoriasis palmoplantaris, psoriasis palmaris et plantaris

Psoriasis predominantly affecting the palms and soles takes two forms:

  • Erythematous scaly plaques typical of psoriasis elsewhere in the body.
  • More generalised thickening and scaling (keratoderma).

Palmoplantar pustulosis (PPP) is a chronic inflammatory skin condition. It is considered by some to be a variation of psoriasis and occurs in patients with other types of psoriasis [1]. However, the nature of the link with psoriasis is unclear and there are significant differences. Neuroendocrine dysfunction of the sweat glands has been implicated in the pathogenesis [2]. See the 'Palmoplantar pustulosis' section at the end of this article.

See also separate Psoriatic Nail Disease article.

The prevalence of psoriasis has increased in the UK in recent years. It was 2.3% (2,297 cases per 100,000) in 1999 but 2.8% (2,815 per 100,000) in 2013 [3]. There was, however, no associated increase in incidence. This suggested that patients with psoriasis were living longer, although reasons for this are unclear. A proportion of these patients, usually with psoriatic lesions elsewhere, will have psoriasis involving the feet and hands.

  • Red scaly plaques.
  • Hyperkeratotic areas.
  • Central palm or weight-bearing areas of the soles.
  • Well demarcated.
  • Painful cracking and fissuring.

See also separate Chronic Plaque Psoriasis article.

  • Classical psoriatic lesions can be treated with a vitamin D ointment (calcipotriol/Dovonex® or tacalcitol/Curatoderm®) or dithranol (Dithrocream®/Micanol®).
  • In palm and sole psoriasis, both hyperkeratosis and inflammation are usually present and may require separate treatments:
    • Hyperkeratosis usually needs to be treated with a keratolytic agent such as 2% salicylic acid ointment BP.
    • This can be alternated morning and evening with a topical steroid (usually potent, due to the thick skin at this site) [1].
  • Where there is diagnostic uncertainty.
  • For further patient counselling and education.
  • Where topical treatment has failed, or treatment has not been tolerated.
  • Where there is significant physical, psychological, social or occupational difficulty.

Further treatment options in secondary care include low doses of oral retinoids with psoralen combined with ultraviolet A (PUVA) or UVB phototherapy, methotrexate, ciclosporin or acitretin. Calcineurin inhibitors such as tacrolimus or pimecrolimus and biological agents such as infliximab and alefacept have been used with some success [5].

Pain can restrict the use of hands or walking.

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However many angry and greedy pharmaceutical companies have requested government organizations in United States to ban the new groundbreaking online video that reveals how to naturally eliminate psoriasis.

They claim it is against capitalistic practices and that it would destroy the psoriasis pharmaceutical industry. They are afraid it will effect their bottom line and put them out of business.

Want to learn how to eliminate your psoriasis? Simply watch this video while you still can.

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Daivobet er et lægemiddel mod psoriasis, som findes både som salve og gel. Det er et lægemiddel med syntetisk fremstillet D-vitamin, som indeholder to aktive stoffer; calcipotriol (D-vitamin) og betamethason. Du kan foretage en hurtig og enkel online konsultation, og godkendes denne af en af vores læger, vil en recept blive udskrevet til dig og sendt til vores apotek. Her vil de sende din Daivobet behandling til dig.

  • Effektiv ved plaque psoriasis (80% af psoriasis-tilfælde)
  • Særligt effektiv mod psoriasis i hårbunden
  • Virker ved at angribe de bagvedliggende årsager til psoriasis

Daivobet er et lægemiddel som anvendes til at mindske inflammation og udbrud af psoriasis. Præparatet bliver fremstillet af den danske lægemiddelproducent Leo Pharma.

Lægemidlet består af to aktive ingredienser, som virker effektivt mod psoriasis:

Calcipotriol og betamethason.

Calcipotriol er et højkoncentrat af D-vitamin, som er det vitamin, der dannes i huden, når du får sollys. Mange psoriasispatienter får netop færre symptomer ved lysbehandling, og calcipotriol giver dig en høj dosis D-vitamin som erstatning for lysterapi.

Betamethason er et anti-inflammatorisk stof, som virker ved at mindske inflammationen i huden ved psoriasis.

Daivobet virker således på de to bagvedliggende årsager til psoriasisudbrud. Når du fx har plaque psoriasis bliver der dannet nye hudceller hurtigere end normalt. Dette bevirker, at huden bliver inflammeret. Og når huden bliver inflammeret, begynder den at skælle og blive irriteret. Ved at behandle både overproduktion af hudceller og inflammation modvirker dette lægemiddel begge årsager til plaque psoriasis.

Cremen eller gelen skal smøres i et jævnt og tyndt lag på de områder, hvor du har psoriasis. Da lægemidlet kan føles lidt klistret, kan det være en god ide at smøre det på om aftenen, så det ikke generer dig i løbet af dagen.

Du behøver ikke bruge en bandage eller forbinding på det ramte område efter behandlingen. En undtagelse er dog ved psoriasis på hænderne, hvor du bør bruge bomuldshandsker bagefter. Det er som altid vigtigt at være omhyggelig med hygiejnen, så forsøg at holde området rent, så du undgår unødige infektioner.

Efter du har smurt Daivobet på din hud, er det vigtigt at vaske hænderne, så du ikke får gnedet salve andre steder på huden eller i øjnene.

Daivobet er en anbefalet behandling til plaque psoriasis, som er den type ca. 80% af psoriasisramte har.

Derimod bør du ikke anvende lægemidlet, hvis du har typerne erytrodermisk, eksfoliativ og pustuløs psoriasis.

Daivobet gel eller salve skal smøres i et tyndt lag på de angrebne områder 1 gang dagligt. For psoriasis i hårbunden er den anbefalede behandlingstid 4 uger, mens den for områder på resten af kroppen er 8 uger. Er der brug for at fortsætte behandlingen længere end denne periode, bør du tale med en læge om det.

Ved lægemidler med calcipotriol bør den samlede dagsdosis ikke være højere end 15 g gel/salve. Og det samlede areal på kroppen, som du smører lægemidlet på, bør ikke være over 30 %. I så fald kan det påvirke kalciummetabolismen, da der kan forekomme hyperkalcæmi, hvis dagsdosis overstiges. Serum-calcium når dog igen et normalt niveau, når behandlingen stoppes. Der er dog minimal risiko for hyperkalcæmi ved den normale anvendelse af lægemidlet.

Du kan bruge Daivobet gel til alle angrebne områder i hårbunden. Normalt er en dosis på 1-4 g daglig nok til behandling af hårbunden (4 g er det samme som en teskefuld).

Lægemidler på recept har altid en vis risiko for bivirkninger, men de er begrænsede for Daivobet salve/gel. De mest almindelige (0-10%) er kløe, udslet og en brændende fornemmelse i huden.

Er du i tvivl om bivirkninger, henviser vi altid til, at du læser indlægssedlen.

Virker daivobet? Ja, Daivobet er en effektiv behandling mod psoriasis. Dels virker lægemidlet ved betamethason (binyrebarkhormon), som dæmper vævsreaktionen. Dels ved calcipotriol (D-vitamin), som begrænser den øgede deling af celler, der ellers sker i hornlaget i huden, når du har psoriasis.

A new psoriasis breakthrough that has already helped over 17,542 psoriasis sufferers in New York and millions worldwide end their psoriasis is currently being attacked by large pharmaceutical companies.

This new breakthrough shared in this online video has helped psoriasis sufferers cure their psoriasis with no side effects and end the need for prescription dugs. Best of all this can all be accomplished with just a few items found in your local grocery store.

However many angry and greedy pharmaceutical companies have requested government organizations in United States to ban the new groundbreaking online video that reveals how to naturally eliminate psoriasis.

They claim it is against capitalistic practices and that it would destroy the psoriasis pharmaceutical industry. They are afraid it will effect their bottom line and put them out of business.

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Att använda bra toalettpapper, luftiga lösa underkläder och även fibertillskott för att hålla magen i trim kan hjälpa till att förhindra uppblossning av psoriasis. Att använda glidmedel eller en glidmedelsbehandlad kondom kan förhindra friktionsskador vid sex.

Det kan vara svårt att avgöra skillnaden mellan genital psoriasis och kontakteksem eller någon annan typ av infektion. Även om du har psoriasis är det inte säkert att ett utslag i underlivet beror på psoriasis. Du bör uppsöka en läkare som kan diagnosticera din hudåkomma om du misstänker att du har genital psoriasis.

Även om det inte finns något känt botemedel, kan tillståndet hållas i schack. Utvärtes krämer och UV-ljus är de vanligaste behandlingarna av genital psoriasis. En vaginal infektion som beror på psoriasis är ett ganska vanligt problem som kan behandlas med potent kortisonkräm. Undvik tätt sittande kläder som kan orsaka klåda och smärta.

Small, light brown scaly papules

Well defined thin furrows running into centre

Oral acitretin or isotretinoin

Carbon dioxide laser ablation

Porokeratosis can develop into skin cancer. If a lump or sore develops within a porokeratosis lesion you get it checked immediately by a doctor or skin specialist.

Porokeratosis has several names that are associated with it. Examples of these variants are basal cell papilloma, senile keratosis, seborrheic verruca, senile warts, barnacles, and brown warts. A cornoid lamella is a sure manifestation of porokeratosis, which is a clonal keratinization disorder. A cornoid lamella is composed of closely stacked parakeratotic cells that extend throughout the stratum corneum.

Currently, there are five variations of porokeratosis that are known. These are linear porokeratosis, porokeratosis palmaris et plantaris disseminate, disseminated superficial actinic porokeratosis, punctate porokeratosis, and classic porokeratosis of Mibelli. Disseminated superficial actinic porokeratosis is rather common in the United States. The other variants of porokeratosis are more rare.

The people who are the most prone to porokeratosis are fair-skinned individuals. In fact, the disorder is not often seen among darker-skinned individuals.

The two variants, orokeratosis palmaris et plantaris disseminate as well as classic porokeratosis of Mibelli, affect twice as many men than women. Disseminated superficial actinic porokeratosis happens 3 times as much in women compared with men. On the other hand, linear porokeratosis occurs in men just as much as it does in women.

With regards to the statistics when it comes to age, porokeratosis palmaris et plantaris disseminate and linear porokeratosis can appear at any age. Meanwhile, classic porokeratosis of Mibelli usually begins to develop starting from childhood. Between 30-40, adults are typically prone to disseminated superficial actinic porokeratosis.

What are the things that can cause porokeratosis? Porokeratosis has been said to be caused by too much exposure to the sun, immunosuppression, ultraviolet light exposure, therapeutic phototherapy, radiation therapy, as well as heredity. A study showed that ten percent of renal transplant patients later developed the skin condition.

Patients of porokeratosis have to make sure that they avoid any unnecessary exposure to the sun. It is advisable that they wear protective clothing as well as use sunblock.

Porokeratosis treatment can be done through many ways. Treatment for this disorder must be individualized. Doctors have to think about certain factors such as the lesion’s anatomical location, the size of the lesion, risk of malignancy, the aesthetic and functional issues, as well as the patient’s preference.

For numerous patients, sun protection as well as the usage of emollients might be all that is required for relief. Patients should also keep a look out for any indications of malignant degeneration.

Porokeratosis treatment can also take the form of surgical care. Surgery is necessary for lesions that have become malignant over time. The most appropriate surgical modality for malignant degeneration is excision. Last but not the least, porokeratosis can also be treated using curettage, diamond fraise dermabrasion, laser therapy, electrodesiccation, as well as cryotherapy and Ag3derm Cream – a topical treatment you can apply at home.

  • Kräver medicinsk diagnos
  • Symptom: Blanka utslag, klåda, sveda eller fjällig hud
  • Färg: Vanligtvis röd
  • Plats: Underlivet, övre delen av låren, hudveck, mellan skinkorna
  • Behandling: Utvärtes krämer eller UV-ljusterapi

Genital psoriasis är psoriasis som uppkommer kring genitalierna. Tillståndet är inte smittsamt och ofta ärft. Genital psoriasis kan utlösas av svampinfektioner, och de med genetisk predisposition är mer mottagliga för psoriasis. Psoriasis visar sig vanligtvis i 20-årsåldern.

Om du har genital psoriasis har du oftast också mer typisk psoriasis på knän och armbågar. För en del kan genital psoriasis dock vara den enda sorten du har.

Genital psoriasis kan ibland visa sig som väl avgränsade, röda blanka utslag på genitalierna hos kvinnor och män. Det kan också dyka upp som jämna, torra, röda hudförändringar, utan det fjällande som är typiskt för andra former av psoriasis. Den vanligaste formen av genital psoriasis är så kallad omvänd psoriasis under brösten, nära ljumskarna och armhålorna. Utslagen brukar klia och svida.

Underlivet
I underlivet brukar utslagen vara symmetriskt spridda över huden på blygdläpparna, och ibland runt anus. Det kan blossa upp på pubis (området ovanför genitalierna), vulva och penis, men drabbar sällan insidan av slidan. Psoriasis på vulva ser ofta ut som en jämn, icke-fjällande rodnad. Att klia på detta område kan orsaka infektion, torrhet, och resultera i förtjockad hud och mer klåda. Psoriasis på penis kan se ut som små, röda fläckar på ollonet och skaftet. Huden kan vara fjällig eller blank och glänsande. Genital psoriasis drabbar både omskurna och icke omskurna män.

Övre delen av låren
Det kan också visa sig på övre delen av låren, och då som små, runda fläckar som är röda och fjälliga. Sitter det mellan låren blir det lätt irriterat, särskilt om låren gnids mot varandra när du går eller springer.

Hudveck
Psoriasis visar sig generellt som icke-fjällande och rödvitt i ljumskar eller nära anus. Huden kan också ha sprickor. Personer som är överviktiga eller atletiska kan ha en infektion kallad intertrigo, vilket visuellt liknar en svampinfektion i hudvecken.

Mellan skinkorna
Psoriasis mellan skinkorna kan vara röd och icke-fjällande eller röd med stora fjäll. Huden i detta område är inte lika ömtålig som i ljumskarna.

Att använda bra toalettpapper, luftiga lösa underkläder och även fibertillskott för att hålla magen i trim kan hjälpa till att förhindra uppblossning av psoriasis. Att använda glidmedel eller en glidmedelsbehandlad kondom kan förhindra friktionsskador vid sex.

Det kan vara svårt att avgöra skillnaden mellan genital psoriasis och kontakteksem eller någon annan typ av infektion. Även om du har psoriasis är det inte säkert att ett utslag i underlivet beror på psoriasis. Du bör uppsöka en läkare som kan diagnosticera din hudåkomma om du misstänker att du har genital psoriasis.

Även om det inte finns något känt botemedel, kan tillståndet hållas i schack. Utvärtes krämer och UV-ljus är de vanligaste behandlingarna av genital psoriasis. En vaginal infektion som beror på psoriasis är ett ganska vanligt problem som kan behandlas med potent kortisonkräm. Undvik tätt sittande kläder som kan orsaka klåda och smärta.

Psoriasis förknippas av de flesta med tjock och torr hud som en hudsjukdom. Men psoriasis klassas som en systemsjukdom eftersom den uppkommer genom ett felaktigt agerande av kroppens eget immunförsvar som orsakar bland annat en kraftig överproduktion av hudceller som på de områden där så sker får tjock hud. Samtidigt räcker inte kroppens mekanism till som annars ska göra huden elastisk och smidig. Huden blir torr, flagar och det kan bildas både var och sprickor.

När solen tittar fram kan den lindra din psoriasis, men det finns ett par saker du bör tänka på! Här kan du läsa mer om psoriasis och solljus.

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