subtypes of psoriases Flashcards
54 year old male presents with a 15 year history of scaly plaques on both elbows. Over the last few months the rash has spread to involve large areas of his body.
He has recently lost his job and has been diagnosed with hypertension.
O/E he has large salmon coloured plaques on his arms, legs and back with thick scale
what does he have?.
chronic plaque psoriases
Chronic plaque psoriases?
almost 90% of psoriases cases
- sever cases with bigger plaques have stronger impact on psycho-social and cardio-vascular health
- commonly managed with topical treatment s in primary care setting
A 14 year old boy presents with an acute onset of a generalized eruption.
O/E he has 2-5 mm multiple salmon colour papules with a fine scale worse on the trunk and proximal extremities.
On direct questioning his mother says that he has had a throat infection 2-3 weeks prior to the rash.
What does he have?
Guttate psoriasis
Guttate psoriasis?
Commonly post-viral
Usually self-limiting
Responds well to phototherapy
May recur in some cases
A 32 year old lady presents with several months’ history of a rash on her hands and feet. She works as a beautician / masseuse and wants it to be cured.
O/E the skin on the palms and soles appears thick, scaly and red with yellowish brown lesions at the edges.
what do they have?
Palmo-plantar Psoriasis
Studies show that psoriasis of the palms and soles tend to have greater impact on the patient’s quality of life compared to those with more extensive psoriatic involvement not involving the palms and soles
27 year old lady presents to your clinic complaining of severe dandruff. She has tried various shampoos with out much effect. She has noticed that the dandruff is spreading on to her face as well.
O/E you note thick hyperkeratotic plaques in the scalp with some pitting of the nails. She also has 2 small plaques of scaly rash on the cheeks.
what do they have?
Scalp Psoriasis
nail psoriasis
ddx of scalp psoriasis?
Seborhoeic dermatitis
pathognomic features?
pitting
onycholysis
36 year old patients presents to you complaining of several months history of rash in his armpits. He has been treated with topical and oral anti-fungal agents in the past with out any benefit. Skin scrapings show no growth.
O/E you note shiny pink to red sharply demarcated plaque with no scaling.
what do they have?
Flexural / Inverse Psoriasis
Lack of scale
50 year old lady presents with an acute onset of generalised red, tender patches. On closer inspection of the patches multiple yellow pustules are seen
pustural psoriases
67 year old patient with 35 years history of Chronic plaque psoriasis. His wife recently died and because his psoriasis started to flare up he was prescribed 2 weeks course of oral Prednisolone. He presents 4 weeks after that feeling generally unwell.
O/E He has generalized erythema of the skin with fine scale. He is pyrexial and has low blood pressure.
what does he have?
Erythrodermic psoriasis
features of erytgrodermic psoriases?
‘Red Man’ syndrome
>90% body surface area involved
Needs In-patient treatment
