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.
Psoriasis is a multifactorial disease with a genetic basis. Exacerbations of disease may be related to infection, alcohol, medications, stress, and intercurrent illness.
Diagnosis is usually clinical.
Mild or limited psoriasis is treated with topical corticosteroids and/or vitamin D analogs.
Moderate to severe and/or extensive psoriasis may require phototherapy, and systemic agents such as methotrexate, cyclosporine, acitretin, or biologic agents.
Psoriasis is a chronic inflammatory skin disease characterized by erythematous, circumscribed scaly papules and plaques. It can cause itching, irritation, burning, and stinging. Although approximately 30% of people with cutaneous psoriasis also have psoriatic arthritis, this topic only discusses cutaneous psoriasis.
History and exam
Key diagnostic factors
- skin lesions
Other diagnostic factors
- family history
- joint swelling or pain
- local trauma
- greater body mass index (BMI)
1st investigations to order
- clinical diagnosis
Investigations to consider
- skin biopsy
- Pityriasis rosea
- Seborrheic dermatitis
- Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures
- EuroGuiDerm guideline on the systemic treatment of psoriasis vulgaris – part 2: specific clinical and comorbid situations
Psoriasis: what is it?
Psoriasis: what treatments workMore Patient leaflets
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer