Psoriasis: Difference between revisions
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==Background== | ==Background== | ||
*Psoriasis is a chronic and relapsing disease | |||
*Often begins in the 2nd or 3rd decade of life | *Often begins in the 2nd or 3rd decade of life | ||
* | *Types: | ||
** | **Plaque: also known as psoriasis vulgaris, makes up about 90 percent of cases. It typically presents as red patches with white scales on top. | ||
Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp. | Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp. | ||
**Guttate: drop-shaped lesions. | |||
**Inverse: red patches in skin folds | |||
**Pustular: presents as small non-infectious pus-filled blisters | |||
**Erythrodermic: occurs when the rash becomes very widespread, and can develop from any of the other types. Fingernails and toenails are affected in most people with psoriasis at some point in time. This may include pits in the nails or changes in nail color. | |||
===Triggers=== | ===Triggers=== | ||
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[[File:Psoriasis2010.jpg|thumb|Psoriatic plaque, showing a silvery center surrounded by a reddened border.]] | [[File:Psoriasis2010.jpg|thumb|Psoriatic plaque, showing a silvery center surrounded by a reddened border.]] | ||
[[File:Psoriasis infliximab ar1182-2.gif|thumb|[[Psoriasis]] before and after treatment.]] | [[File:Psoriasis infliximab ar1182-2.gif|thumb|[[Psoriasis]] before and after treatment.]] | ||
*Well-demarcated erythematous plaques and papules with silvery white scales | *Well-demarcated erythematous plaques and papules with silvery white scales | ||
**Epidermal hyperproliferation | **Epidermal hyperproliferation | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Generalized rash DDX}} | {{Generalized rash DDX}} | ||
==Evaluation== | |||
*Generally a clinical diagnosis | |||
==Management== | ==Management== | ||
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*Hydrocortisone cream 1% | *Hydrocortisone cream 1% | ||
*Systemic steroids should be avoided due to the risk of developing rebound or induction of pustular psoriasis | *Systemic steroids should be avoided due to the risk of developing rebound or induction of pustular psoriasis | ||
==Disposition== | |||
*Discharge | |||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | |||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
Revision as of 06:03, 5 November 2017
Background
- Psoriasis is a chronic and relapsing disease
- Often begins in the 2nd or 3rd decade of life
- Types:
- Plaque: also known as psoriasis vulgaris, makes up about 90 percent of cases. It typically presents as red patches with white scales on top.
Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp.
- Guttate: drop-shaped lesions.
- Inverse: red patches in skin folds
- Pustular: presents as small non-infectious pus-filled blisters
- Erythrodermic: occurs when the rash becomes very widespread, and can develop from any of the other types. Fingernails and toenails are affected in most people with psoriasis at some point in time. This may include pits in the nails or changes in nail color.
Triggers
- Stress
- Trauma
- Drugs: NSAIDs, B-blockers
Clinical Features
Psoriasis before and after treatment.
- Well-demarcated erythematous plaques and papules with silvery white scales
- Epidermal hyperproliferation
- Commonly found on the trunk, scalp, nail pitting, and extensor surfaces
- Auspitz sign: plaque removal reveals pinpoint-bleeding areas
- Associated with psoriatic arthritis, especially in nail involvement
Differential Diagnosis
Other Rash
- Acute generalized exanthematous pustulosis
- Allergic reaction
- Aphthous stomatitis
- Atopic dermatitis
- Coxsackie
- Dermatitis herpetiformis
- Exfoliative erythroderma
- Impetigo
- Pellagra
- Pityriasis rosea
- Serum Sickness
- Tinea capitus
- Tinea corporis
- Vitiligo
Evaluation
- Generally a clinical diagnosis
Management
- Ketoconazole 2% shampoo
- Hydrocortisone cream 1%
- Systemic steroids should be avoided due to the risk of developing rebound or induction of pustular psoriasis
Disposition
- Discharge