Psoriasis (Updated), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Psoriasis, Diagnosis and Treatment and Related Diseases
Last week I saw a new patient who was referred to me by another skin patient.
She had psoriasis for the past 3 years and had seen many doctors for her psoriasis without improvement.
She is slightly obese, 55 years of age and Malay.
She has psoriasis all over her body except for the face and hands.
The psoriatic rashes were covered up as she did want any one near to see her in that state.
Among the medicines that she was given were methotrexate tabs and prednislone tabs.
She was given some moisturizer to apply on her rashes.
She did not know what could have triggered her psoriasis.
There were no severe infections or injury before the onset of her psoriasis.
However she was particularly stressed about her husband’s gambling and drinking problems.
There was no food or soap allergy.
The first thing that I advised was to rest and not be stressed about her husband because stress is one of the causes of psoriasis.
The second thing was to lose some weight because it has been shown that psoriasis is aggravated by obesity and over weight.
She has to control her diet to lose some weight.
The third thing was to expose her arms and the rest of the body to some sunlight at home since the face and uncovered areas of the body were not affected.
Probably her skin may benefit from some UV sunrays exposure.
The fourth thing was to give her steroid cream to apply on her skin thinly.
I also advised her to use coal tar soap for bathing or use an oatmeal bath which is good for removing the scales on the skin
Finally I gave her methotrexate injection in low dose.
Apparently the methotrexate tablets she was given did help to improve her skin but she had some nausea after taking after a few days so she stopped the oral tablets herself and changed to another doctor.
She was also given low dosage of dexamethasone and antihistamine and advised not to scratch her rashes. Scratching is one of the worst things to do in any rashes because it always aggravates the skin condition.
She was also told to drink lots of water which always help to flush out toxins from the body.
She was told to see me after 2 weeks

While there is still no recovery for psoriasis, new treatments now permit millions of people who live with this inflammatory skin disorder to sport short sleeves once again.
One expert even called it the most unbelievable time in the treatment of psoriasis.
Interleukin blockers
For the first time, the newest biologics can transform someone from having psoriasis to no psoriasis.
The skin is completely clear
Administered by shot or intravenous (IV) infusion, biologics are kept in reserve for people with moderate to severe psoriasis.
The newest group of biologics gets even more specific in their focus, making them that much more effective and safe.
The most interesting new treatments for psoriasis are Tremfya, Cosentyx, Siliq, and Taltz
They clear most patients who obtain them and have very few side effects
There are some new combinations of topical steroids and vitamin D that have interventions against the inflammation and scaling of psoriasis
Taclonex ointment is a once-daily medicine for psoriasis that is given for up to eight weeks to treat scalp and body plaque psoriasis
Weight loss
Psoriasis being more than skin deep has made weight loss a main part of treatment.
Weight loss works wonders
Phototherapy has been an important part in psoriasis treatment but today’s treatments are more effective and safer.
Narrowband ultraviolet B (UVB) devices and excimer lasers can now help clear psoriasis
More new treatments for psoriasis are:
IDP-118
IASIS topical use
A new tyrosine kinase 2 (TYK2) inhibitor
Tofacitinib citrate

TABLE OF CONTENT
Introduction
Chapter 1 Psoriasis
Chapter 2 Causes
Ch

• Language: English
• Publisher: Kenneth Kee
• Release date: Oct 28, 2018
• ISBN: 9780463745793

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Psoriasis (Updated),

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Psoriasis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Psoriasis)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog: http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Psoriasis

Chronic Psoriasis

1. Last week I saw a new patient who was referred to me by another skin patient.

She had psoriasis for the past 3 years and had seen many doctors for her psoriasis without improvement.

She is slightly obese, 55 years of age and Malay.

She has psoriasis all over her body except for the face and hands.

The psoriatic rashes were covered up as she did want any one near to see her in that state.

Among the medicines that she was given were methotrexate tabs and prednislone tabs.

She was given some moisturizer to apply on her rashes.

She did not know what could have triggered her psoriasis.

There were no severe infections or injury before the onset of her psoriasis.

However she was particularly stressed about her husband’s gambling and drinking problems.

There was no food or soap allergy.

The first thing that I advised was to rest and not be stressed about her husband because stress is one of the causes of psoriasis.

The second thing was to lose some weight because it has been shown that psoriasis is aggravated by obesity and over weight.

She has to control her diet to lose some weight.

The third thing was to expose her arms and the rest of the body to some sunlight at home since the face and uncovered areas of the body were not affected.

Probably her skin may benefit from some UV sunrays exposure.

The fourth thing was to give her steroid cream to apply on her skin thinly

I also advised her to use coal tar soap for bathing or use an oatmeal bath which is good for removing the scales on the skin..

Finally I gave her methotrexate injection in low dose.

Apparently the methotrexate tablets she was given did help to improve her skin but she had some nausea after taking after a few days so she stopped the oral tablets herself and changed to another doctor.

She was also given low dosage of dexamethasone and antihistamine and advised not to scratch her rashes. Scratching is one of the worst things to do in any rashes because it always aggravates the skin condition.

She was also told to drink lots of water which always help to flush out toxins from the body.

She was told to see me after 2 weeks.

2. Every week for the past 15 years I have been giving this 50 year woman her subcutaneous dose of methotrexate starting with 0.7ml, then 1.0 ml and now 0.9ml in her arms.

It was an unpleasant experience for her with some nausea just smelling the medicine but she was told by her skin specialist to have it done for the sake of controlling her psoriasis.

It was not a pleasant experience for me either because it can cause her some pain.

She already had suffered from psoriasis since 25 years old and her left finger joints had become deformed because of psoriatic arthritis.

She also had side effects from the steroids that she had been taking since her psoriasis.

Nevertheless her psoriasis had improved greatly until her skin is fairly smooth.

But once she had stress, the plagues would start flaring up again

At one stage it was bad that they become infected and ulcerated and she had to be admitted to hospital for antibiotic treatment and daily dressing of her wounds

At the present moment she is still under control with her methotrexate and steroid.

She did ask to be given some of the newer drugs such as biologics and new immunosuppressants but her request was turned because of her age and her present controlled condition..

She was not the only psoriasis patient that I had.

There was another younger man of 35 years or so who had so severe psoriasis that his body was covered with plagues to the extent that his movement was also restricted by the thickened skin.

I had to apply moisturizer and steroid ointments to soften the psoriasis plagues so that he could move easier.

In the end he had to be admitted to hospital for continuous treatment of his psoriasis.

What is Psoriasis?

Psoriasis is a disorder of the skin which normally consists of red patches covered by silvery-white scales especially around the