Case Report: Reynolds Syndrome

Imaging Journal of Clinical and Medical Sciences

Case Blog

A Painful Case of Debilitating Cutaneous Psoriasis

Psoriasis is an immune mediated, chronic inflammatory, incurable condition of the skin that affects 2-3% of the population globally. It is associated with red, thick, scaly lesions [1], is more common in patients on higher latitudes, in Caucasians and may manifest itself with an underlying arthropathy. Psoriasis has a spectrum of presentations ranging from localized, mild disease to involvement of more than 90% of the body’s surface called erythrodermic form [2]. In as many as 4% of the patients with psoriatic the first sign of disease involves changes to the nail, however, these nail changes are seen in about half patients at some point in the course of the disease. Arthropathy, specifically, Psoriatic arthritis is also seen in about 5-10% of this patient population [3]. Pathogenesis involves the secretion of cytokines such as IL-2, Interferon- γ, TNF-α by the T cells that are involved in the induction of proliferation with decreased maturation of keratinocytes [1,4,5]. The Cytokine TNF-α is one of the central immunomodulators involved in the pathogenesis of psoriasis and is also elevated in the skin of patient with psoriasis [6]. Traditional treatment involves the use of steroids, phototherapy, systemic retinoids, methotrexate and cyclosporine. In recent years the focus has shifted to TNF-α blocking agents especially in patients with psoriatic arthritis [7].

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