Skin disorders clinical presentation

Psoriasis is a common inflammatory skin disorder which is estimated to affect 1.5% to 3% of the Caucasian population.1,2 It may present at any age.3,4 Ethnic factors influence disease prevalence. In the United States, prevalence among blacks (0.45% to 0.7%) is lower than in the remainder of the United States population (1.4% to 4.6%).1 Between 10% and 30% of patients with psoriasis will also have psoriatic arthritis.5 In 10% to 15% of psoriatic patients with arthritis, joint symptoms actually appear prior to skin involvement.3 Clinical depression is another frequent comorbid illness in these patients. A recent United States survey showed that 8% to 10% of psoriatic patients aged 18 to 54 years old actively contemplated suicide because of their psoriasis.6... 

In a survey of patients about the sources of advice they use for skin conditions, pharmacists ranked second, just behind physicians. Interestingly, the advice sought seemed to depend on the nature of the condition, in that patients sought more pharmacist advice on conditions such as dermatitis, psoriasis, skin cancer, and acne. To properly assess a patient, pharmacists and other primary care providers must not only understand clinical presentations of common skin disorders, but they must also be able to quickly identify patients that may need referral for further evaluation by a physician. 

At the present time, rotenone (35) and related compounds could have more ample applications. Several rotenoids from P. erosus have shown antitumoral activity [67]. A number of pharmacological, toxicological and clinical studies need to be conducted with P. erosus rotenoids, including systematic testing in scabies and other skin disorders caused by mites. This could open a new chapter in the history of this plant, developing its potential as a new phytopharmaceutical. 

These are the major, and oftimes the only, symptoms associated with this disorder. Although acute and chronic zinc deficiency syndromes can also be characterized by taste and smell dysfunction they also have other, more easily recognized dysfunctions affecting skin, gastrointestinal tract, neuromuscular system or other body systems allowing their diagnosis to be made somewhat easier. Of all the zinc deficiency syndromes only subacute zinc deficiency can present with taste. and smell dysfunction as the major or only set of clinical symptoms manifested by the condition. 

In Refsum s disease, an autosomal recessive disorder, the defect is probably in the a-hydroxylation of phytanic acid. Phytanic acid is a 20-carbon, branched-chain fatty acid derived from the plant alcohol phytol, which is present as an ester in chlorophyll. Thus, its origin in the body is from dietary sources. The oxidation of phytanic acid is shown in Figure 18-6. The clinical characteristics of Refsum s disease include peripheral neuropathy and ataxia, retinitis pigmentosa, and abnormalities of skin and bones. Significant improvement has been observed when patients are kept on low-phytanic acid diets for prolonged periods (e.g., diets that exclude dairy and ruminant fat). 

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