Lexie Nall

The Natural History of Psoriasis in 5,600 Patients

The natural history of psoriasis was studied through a questionnaire survey of 5,600 patients throughout the United States. The mean age of onset of psoriasis was 27.8 years. 36% of the respondents reported familial occurrence of the disease. At the time of study, the lower extremities were indicated as being the most often affected; trunk, elbow, and scalp were next, knee and face were cited less frequently. Fingernails were involved in half of the patients at some time during the period of their disease. In the majority of patients, hot weather and sunlight had a beneficial effect. One third of the females also indicated improvement during the course of pregnancy. Remissions were reported in 39% of the patients.

Tinea versicolor: Epidemiologic, clinical, and therapeutic aspects

Age of the patient, climate, season, and local environmental factors influence the onset and course of tinea versicolor (pityriasis versicolor). A number of effective topical therapies are available. In addition, a single dose of 400 mg of oral ketoconazole eliminates the disease and can be used prophylactically in some cases to prevent recurrence.

Psoriasis: A disease of the total skin

Psoriasis is a disease of the total skin, which becomes clinically evident when a psoriatic lesion appears following an injury to the symptomless skin of a psoriasis patient. Although not all biopsy specimens of the symptomless skin show pathologic findings, the evolution of a psoriatic plaque can be envisioned as developing from the nonvisible phases of residual psoriasis, prepsoriasis, and latent psoriasis into a visible state where macules evolve into papules and papules coalesce to form plaques.