Immune-mediated hyperproliferative skin disease with well-demarcated scaly plaques and systemic associations.
Clinical features
- • Salmon-pink plaques with silvery scale on extensor surfaces
- • Nail pitting and onycholysis
- • Scalp involvement
- • Joint pain in 20–30%
Management
- • Topical potent steroid plus vitamin D analogue for 4 weeks
- • Coal tar or dithranol for chronic plaques
- • Phototherapy (narrowband UVB) for extensive disease
- • Systemic: methotrexate, ciclosporin, acitretin
- • Biologics (anti-TNF, IL-17, IL-23) for severe disease
Complications
- • Psoriatic arthritis
- • Erythroderma and generalised pustular psoriasis
- • Metabolic syndrome and cardiovascular risk
- • Depression
Clinical pearls
- • Oral steroids can precipitate pustular flare on withdrawal — avoid
- • Screen annually with PEST questionnaire for arthritis
Related in WardRound
Educational — verify locally.
