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Psoriasis

Karl T. Clebak, FAAFP, MHA, MD and Roland W. Newman II, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A chronic, inflammatory disorder commonly characterized by cutaneous erythematous plaques with silvery scale with varying phenotypes and severity

  • Clinical phenotypes

    • Plaque (vulgaris):...

DIAGNOSIS

HISTORY

  • May include: sudden onset of clearly demarcated, erythematous plaques with overlying silvery scales or exacerbation of chronic plaques, especially on extensor surfaces and scalp. Typi...

TREATMENT

GENERAL MEASURES

Adequate topical hydration (emollients); avoidance of triggers; weight loss 

MEDICATION

First Line

  • Assess for concurrent psoriatic arthritis, if present start with therapies wit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Measure BSA involvement to determine if therapy is working; change therapy or add agent if no improvement is seen. 

DIET

Well-balanced diet and exercise to limit ca...

REFERENCES

1
Armstrong AW, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis. JAMA. 2020;323(19): 1945-1960.
2
Mason  AR, Mason  J, Cork  M, et al. Topica...

ADDITIONAL READING

  • Clebak KT, Helm L, Helm MF, Seiverling EV. The many variants of psoriasis. J Fam Pract. 2020 May;69(4):192-200. PMID: 32437484.

  • Sendur N, Buy...

SEE ALSO

Arthritis, Psoriatic 

CODES

ICD10

  • L40.2 Acrodermatitis continua

  • L40.5 Arthropathic psoriasis

  • L40.59 Other psoriatic arthropathy

  • L40.1 Generalized pustular psoriasis

  • L40.9 Psoriasis, unspecified

  • L40 Psoriasis

  • L40.0 Psoriasis vulga...

CLINICAL PEARLS

Chronic lifelong inflammatory skin condition with remissions and exacerbations; set realistic expectations with patient. Disease burden not limited to skin. If one medication does not ...

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