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Psoriasis

Michael O. Needham, MD and Rebecca Matz, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A chronic, inflammatory disorder most commonly characterized by cutaneous erythematous plaques with silvery scale. It is a complex immune-mediated disorder that results from a polyge...

DIAGNOSIS

HISTORY

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

TREATMENT

GENERAL MEASURES

Adequate topical hydration (emollients); avoid triggers; weight loss 

MEDICATION

First Line

  • Mild-to-moderate disease

    • Emollients BID: petrolatum/ointments to maintain skin hydra...

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
Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriati...

ADDITIONAL READING

Galván-Banqueri M, Marín Gil R, Santos Ramos B, et al. Biologic treatments for moderate-to-severe psoriasis: indirect comparison. J Clin Pharm Ther.  2013;38(2):121–130. [View...

SEE ALSO

Arthritis, Psoriatic 

CODES

ICD10

  • L40.9 Psoriasis, unspecified

  • L40.50 Arthropathic psoriasis, unspecified

  • L42 Pityriasis rosea

  • L40.4 Guttate psoriasis

  • L40.0 Psoriasis vulgaris

  • L40.8 Other psoriasis

ICD9

  • 696.1 Other psoriasis

  • 696.0 ...

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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