Psoriasis

Question 1

State the most likely causes of psoriasis like rash

Answer 1

Plaque psoriasis

scalp psoriasis

Question 2

Likely cause of psoriasis like rash

Answer 2

seborrheic dermatitis, medicine induced exacerbated psoriasis

Question 3

Clinical features of plaque Psoriasis

Answer 3

salmon pink lesions with silvery white scales
well defined boundaries
lesions can be single or multiple and very in size

Question 4

Specific question to ask the patient

Answer 4

onset- psoriasis can develop in patients of any age, although it first occurs most commonly in early adult life. atypical in younger and older patients

distribution of rash- symmetrical distribution in psoriasis, affects the scalp and extensor aspect of the elbows and knees. the gluteal cleft and umbilicus can also be affected
lichen planus( inside wrist) and  pityriasis rosea (thighs and trunk)

other symptoms- itch is not normally the predominant feature of psoriasis unlike dermatitis and fungal infections
nail involvement in the form of pitting and separation of nail plate from the nail bed - seen in patient with long standing psoriasis

look of rash- scaling as a obvious feature in scalp and plaque psoriasis, this is not seen in dermatitis

Previous history of lesions- patient might have had lesions in the past because it is chronic relapsing and remitting disease

Shx such as drinking and smoking as it exacerbate the condition
pustules? needs referral

Question 5

treatment of psoriasis

Answer 5

Emollients such as double base, diprobase and cetraben

tar based product such as Alphonsyl

Question 6

triggers in psoriasis

Answer 6

stress, alcohol, smoking can exacerbate the condition

Question 7

when to refer

Answer 7

no family history or past history
pustular lesions
extensive lesions , follow recent infection or cause itching