Psoriasis

Psoriasis

Psoriasis is a chronic inflammatory skin condition

Immune-mediated inflammatory disease

It is characterized by clearly defined, red and scaly plaque

Peak onset at 15-26 years and then 50-60 years

Can affect any race but Caucasians more commonly affected

It may appear as a well-demarcated patch

Types

Flexural psoriasis

Plaque psoriasis

Guttate psoriasis/ Post streptococcal

Scalp psoriasis

Palmoplantar psoriasis

Nail psoriasis

Predisposing factors

Streptococcal tonsillitis and other infections

Sun exposure in 10% (sun exposure is more often beneficial)

Obesity

Alcohol Xs

Smoking

Stress

Injuries such as cuts and sunburn

Medications such as beta-blockers, antimalarials, nonsteroidal anti-inflammatories 

Clinical features

Red scaly plaques with well-defined edges.

The scale is typically silvery white, except in skin folds

Mild itching

Common sites

Scalp

Elbows

Knees

Diagnosis

Clinical diagnosis

Management

Smoking cessation

Avoid excess alcohol

Topical therapy

Emollients

Topical corticosteroids

Coal tar preparations

Dithranol

Salicylic acid

Combination calcipotriol/betamethasone dipropionate ointment/gel

Vitamin D analogue (calcipotriol)

Systemic therapy

Methotrexate

cyclosporin

Azathioprine

Biologics

TNF- inhibitor

Flexural psoriasis

Guttate Psoriasis