Psoriasis: Difference between revisions
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*Commonly found on the trunk, scalp, nail pitting, and extensor surfaces | *Commonly found on the trunk, scalp, nail pitting, and extensor surfaces | ||
*Auspitz sign: plaque removal reveals pinpoint-bleeding areas | *Auspitz sign: plaque removal reveals pinpoint-bleeding areas | ||
*Associated with [[psoriatic arthritis]], especially in nail involvement | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 04:39, 17 February 2016
Background
- Often begins in the 2nd or 3rd decade of life
- Chronic and relapsing
Triggers
- Stress
- Trauma
- Drugs
Clinical Presentation
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
Management
- Ketoconazole 2% shampoo
- Hydrocortisone cream 1%
- Systemic steroids should be avoided due to the risk of developing rebound or induction of pustular psoriasis
See Also
Sources
- Uptodate
- Hess MR, Hess SP: Skin Disorders Common on the Trunck, in Tintinalli JE, Kelen GD, Stapczynski JS (eds): Emergency Medicine, A Comprehensive Study Guide, ed 7. New York, McGraw-Hill, 2011, (Ch) 249:p 1653-1654