4 The clinical presentation of drug-provoked psoriasis spans the spectrum of generalized plaque psoriasis, palmoplantar pustulosis, and erythroderma. Patients can have exacerbation of pre-existing psoriatic lesions or develop new lesions in previously uninvolved skin. Reports of lithium-provoked psoriasis in the literature include new onset of pustular psoriasis, palmoplantar pustulosis, erythroderma, psoriasiform dermatitis, psoriatic arthropathy, and psoriasis involving the nail and scalp. Recent streptococcal throat infection, viral infection, immunization, use of antimalarial drug, or trauma. (except in pustular or erythrodermic psoriasis, in which the patient may have high fever). Plaque psoriasis: Most commonly affects the extensor surfaces of the knees, elbows, scalp, and trunk. Intramuscular corticosteroids (eg, triamcinolone): Requires caution because the patient may have a significant flare as the medication wears off. Psoriasis Online Medical Reference – from diagnosis through treatment. Plaque-type psoriasis, or psoriasis vulgaris, is the most common form, occurring in about 80 of all psoriasis patients. The average age at onset for pustular psoriasis is 50 years.
Drugs that can trigger the disease, worsen symptoms, or cause a flare-up include:. Keywords: plaque, psoriasis, children, treatment. Streptococcal infection can provoke guttate psoriasis and childhood pustular psoriasis. Like in adults, HIV infection can induce or exacerbate psoriasis. Rebound of psoriasis following discontinuation of the drug has been reported. Pustular Psoriasis Induced by Infliximab.
Overview. This trial has been completed. This is a response-driven study of tildrakuzumab for the treatment of moderate to severe chronic plaque psoriasis. The most common skin eruption was pustular psoriasis; 10 patients had psoriasis vulgaris, whereas only one patient had the guttate variety, and another had both the guttate and vulgaris forms. Certainly, a flare may not be reported in a patient with underlying psoriasis or psoriatic arthritis receiving TNF antagonists, but new-onset palmopustular eruptions would stand out. Another drug-induced skin eruption, interstitial granulomatous dermatitis, has been described after exposure to TNF antagonists, but these lesions appear as erythematous annular plaques on the trunk and extremities, and histopathological studies show mixed interstitial granulomatous infiltrates of lymphocytes, eosinophils and lymphocytes. Psoriasis predominantly affecting the palms and soles takes two forms:. 3 A proportion of these patients, usually with psoriatic lesions elsewhere, will have psoriasis involving the feet and hands. See also the separate article on Chronic Plaque Psoriasis. NEW – log your activity. Further treatment options in secondary care include low doses of oral retinoids with Psoralen combined with ultraviolet A (PUVA) or UVB phototherapy, methotrexate, ciclosporin or acitretin.
Psoriatic arthritis is a type of inflammatory arthritis that will develop in up to 30 percent of people who have the chronic skin condition psoriasis. Psoriasis can also cause changes to the nails, such as pitting or separation from the nail bed, 4 onycholysis, hyperkeratosis under the nails, and horizontal ridging. Typically the medications first prescribed for psoriatic arthritis are NSAIDs such as ibuprofen and naproxen, followed by more potent NSAIDs like diclofenac, indomethacin, and etodolac. Psoriasis is an immune-mediated, genetic disease manifesting in the skin or joints or both.