Conversation: The conversation between human and AI assistant.
[|Human|] hI sir, I have psoriasis for the past 10 years on my left ankle.whenever i apply propygenta nf cream on top of it,it ll get subsided.but now i m able to visualize the symptoms(itching,scaly occurrence) around elbows,knees and itching around my private area n anus.pls help to sort out this problem as it s frustrating me a lot n makes me afraid of going out.
[|AI|]  Hello. Thanks for writing to psoriasis is a chronic immune mediated disease characterized by scaly plaques on various body sites, characteristically extensors like scalp, elbows, knee, ankles etc. There is a variant of psoriasis which can affect the flexes like groins and perineal area, called as Sebopsoriasis. However, it can be easily confused with a fungal infection, which is fairly common in these areas (body folds). Therefore, I would suggest that you seek an appointment with a dermatologist, to establish as to what is the exact nature of the involvement in body folds, whether psoriasis or fungal infection? As far as the topical cream that you have been using, it contains a potent topical steroid (clobetasol propionate). It is effective in psoriasis because psoriasis is a steroid responsive dermatitis, but psoriasis can relapse again after seemingly complete cure. Topical steroids have a downside to them. They cannot be used over a long term because they can induce skin atrophy. Therefore, it is always advisable to use topical steroids under the supervision of a dermatologist. A dermatologist would be able to look for any early signs of atrophy and therefore can substitute or change the medicine. Apart from topical steroids various treatment option available for psoriasis are: topical coal tar and alicyclic acid, topical vitamin D analogues, topical Morales. Systemic treatment options are: oral Morales and UV A therapy (PVA), NB- UVB phototherapy. Oral Methotrexate, oral cyclosporin etc. Choice of treatment depends on the severity, extent of involvement and the feasibility of treatment options. This can only be discussed in person with a dermatologistTherefore I would reiterate that any treatment, whether topical or oral, should always be taken under the careful supervision of a dermatologist. Regards