Psoriatic lesions are red, inflamed, silvery-white scaly, and circumscribed papules and plaques; often affecting elbows, knees, extensor limbs, and scalp, and, less commonly, nails, ear, and umbilical region.
Typically lifelong, with a fluctuating course of exacerbations and remission of lesions, which may be aggravated by genetic, infectious, emotional, and environmental factors.
Diagnosis is usually clinical.
Mild or limited psoriasis is treated with topical corticosteroids and/or vitamin D analogues.
Moderate to severe and/or extensive psoriasis may require phototherapy, and systemic agents such as oral retinoids, methotrexate, biological agents, ciclosporin or apremilast.
Psoriasis is a chronic inflammatory skin disease characterised by erythematous, circumscribed scaly papules, and plaques. It can cause itching, irritation, burning, and stinging. Although the classification typically includes psoriatic arthritis, skin manifestations only are discussed in this topic.
History and exam
Andrea Chiricozzi, MD
University of Pisa
University Hospital of Pisa
AC has served as an advisory board member and has been reimbursed as a consultant and/or speaker or has participated in clinical trials for AbbVie, Almirall, Fresenius Kabi, Leo Pharma, Lilly, Janssen, Pfizer, Sanofi Genzyme, UCB-Pharma and Novartis; AC is also the author of references cited in this topic.
Dr Andrea Chiricozzi would like to gratefully acknowledge Dr April W. Armstrong and Dr Tsu-Yi Chuang, previous contributors to this topic.
TC declares that he has no competing interests. AWA is an investigator and consultant for Abbott, Amgen, and Janssen; AWA is also the author of references cited in this topic.
David Burden, MD, FRCP
Western Infirmary, Glasgow
Consultant Dermatologist Dermatology
DB is an author of a clinical practice guideline referenced in this topic. DB has been reimbursed as a consultant, researcher, and lecturer for Abbott, Leo, Pfizer, Merck, Janssen-Cilag, and Novartis.
Paradi Mirmirani, MD
Department of Dermatology
Kaiser Permanente Vallejo Medical Center
PM declares that she has no competing interests.
Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures external link opens in a new windowMore guidelines
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