Psoriasis

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Background

  • Well-demarcated erythematous plaques and papules with silvery white scales
    • Epidermal hyperproliferation
  • Often begins in the 2nd or 3rd decade of life
    • Chronic and relapsing

Triggers

  • Stress
  • Trauma
  • Drugs

Clinical Presentation

  • Commonly found on the trunk, scalp, nail pitting, and extensor surfaces
  • Auspitz sign: plaque removal reveals pinpoint-bleeding areas

Management

  • Ketoconazole 2% shampoo
  • Hydrocortisone cream 1%

Pitfalls

  • Systemic steroids should be avoided due to the risk of developing rebound or induction of pustular psoriasis

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