Dermatology Made Simple : Psoriasis : Clinical Presentation:

Psoriasis : Clinical Presentation:

Usually,the patients present with plaques on the elbows,knees, and scalp.

Lesions on the  trunk are usually annular.

Psoriatic lesions may develop in scars and areas of minor skin trauma,this is called as Koebner”s phenomenon.

Scales may develop on scalp in 50 % of patients.

There may be small pits on the nails and separation of nail from nail bed can occur,a process called as Onycholysis

Guttate Psoriasis:

This consists of widespread small plaques scattered on the trunk and limbs.

It is usualy preceded by a Gp B haemolytic streptococcal pharyngitis and affects adolescents mostly.

There is a family history in most of cases.

In most cases,it resolves completely.

There may be history of recurrence.

Pustular psoriasis:

This occurs as chronic deep seated lesions on the palms and soles.

Scales develop in most of the cases and there is a surrounding erythema as well.

There is a known association with smoking.

Severe form of psoriasis may be associated with generalized pustular psoriasis.

It maybe precipitated by the use of oral steroids.

Flexural Psoriasis:

This produces well – defined erythematous areas in the axillae,groin and natal cleft,beneath the breasts and in skin folds.

Scaling is minimum and maybe absent.

Erythrodermic Psoriasis:

This is a serious and sometimes life threatening condition with confluent erythema affecting nearly all of the skin.

Characteristic scaling of psoriasis may be absent.

It may lead to heat and water loss.

Patients should be hospitalized.