Psoriasis is a long lasting immunological assisted skin disease along with many extra cutaneous manifestations, with substantial genetic and environmental influences. It affects about 1.5-3% of the world's population, though commonly not life threatening, but then again causes significant morbidity and has no remedy. We conducted a systematic search on the sites like Pub Med, Embase, Scopus, and multiple databases. The literature search included MeSH-terms and text words, in the following combination such as Blepharitis, dry eye, psoriasis, uveitis, immunological assisted skin disease. No restrictions were followed in terms of publication dates. The reference lists of included articles were screened for additional references. Psoriatic ocular findings may include conjunctivitis, dry eye, blepharitis, squamous intraepithelial neoplasm of the conjunctiva, corneal abscess and immune-mediated conditions such as uveitis, all of which may lead to articular changes. Its pathogenesis is very complicated and involves many molecules like T cells, APCs, keratinocytes, Langerhans cell, macrophages, NK cells, an array of Th1-type cytokines along with certain growth factors like VEGF, KGF which are instrumental in the development of psoriasis. Moreover, ocular disorders are characterized by a series of interconnected cellular changes in the skin like hyperplasia of epidermal keratinocytes, vascular hyperplasia and ectasia, and infiltration of T lymphocytes, neutrophils, and other types of leukocyte in the affected skin. Generally, ocular complications are managed with nonsteroidal anti-inflammatory drugs, corticosteroids, and immunosuppressive agents. Surgical therapy should be carried out, when there are chances of visual disturbance. Timely and correct diagnosis with quick treatment or referral to an ophthalmologist may prevent systemic and ocular disorders. This review highlights the association of psoriasis and ocular disorders with their clinical sign and symptoms.

Prurigo pigmentosa is a rare pruritic inflammatory dermatosis with a unique staged clinicopathological presentation. It was first reported by Nagashima in 1971, and recently, more cases have been reported We introduce a case of a young Saudi female who developed biopsy proved prurigo pigmentosa after she followed strict ketogenic diet. Her condition resolved after she resumed a regular diet.

Adalimumab is a fully human, recombinant, IgG1 monoclonal antibody that targets tumor necrosis factor-alpha (TNF-alpha). It has been established that adalimumab can cross the placenta and can be detected in the fetal circulation for up to 6 months postpartum. However, clinical studies have failed to show any consistent or specific adverse fetal outcomes from maternal exposure to adalimumab during pregnancy. In our report, we present a case of fetal acrania (exencephaly) in the setting of a pregnant female taking adalimumab prior to and during pregnancy. Exencephaly is a neural tube defect (NTD) that results from failure of closure of the neural fold. It is true that there were other risk factors that might have contributed to our patient’s unfortunate outcome. For example, she did not take folic acid supplementation prior to or during her pregnancy. Nonetheless, studies have shown that folic acid deficiency alone is not sufficient to lead to the development of NTDs. Our patient’s exposure to adalimumab during her pregnancy might have added to the risk in her situation. Our report aims to inform clinicians of that possible risk and to stimulate them to report any similar outcomes.