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Psoriasis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Chronic, noncontagious, inflammatory skin condition

  • Disease of hyperproliferation

  • Recently classified as an autoimmune disease

  • Presents with erythematous plaques with silver scaling

  • Most...

Diagnosis

Signs and Symptoms

History

  • Long standing area of scaling erythema

  • May give a history of previous diagnosis of psoriasis

  • May be mildly pruritic

  • May relate to one of the above triggers

  • Specific loca...

Treatment

Pre-Hospital

  • Maintain universal precautions

  • IV access and pain control as necessary

Initial Stabilization/Therapy

  • General resuscitation efforts aimed at correcting fluid and electrolyte abnormal...

Follow-Up

Disposition

Admission Criteria

Acute erythroderma and acute pustular psoriasis warrant admission for supportive therapy and systemic treatment, as noted above. 

Discharge Criteria

  • Advise patient...

Pearls and Pitfalls

  • Patients with pustular psoriasis are at risk for severe systemic infections

  • Patients with erythrodermic psoriasis are at risk for dehydration and may need to be treated similarly to...

Additional Reading

  • Busch  AL, Landau  JM, Moody  MN, et al. Pediatric psoriasis. Skin Therapy Lett. 2012;17:5–7.

  • Cohen  SN, Baron  SE, Archer  CB, et al. Guidance on the diagnosis and clinical manageme...

Codes

ICD9

  • 696.0 Psoriatic arthropathy

  • 696.1 Other psoriasis

ICD10

  • L40.0 Psoriasis vulgaris

  • L40.4 Guttate psoriasis

  • L40.9 Psoriasis, unspecified

  • L40.1 Generalized pustular psoriasis

  • L40.50 Arthropathic psoria...

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