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Other presentations, such as guttate, pustular, erythrodermic, inverse, and nail psoriasis also occur ()

Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types. 16 APP tends to occur in women more frequently than in men, and is usually less severe than other forms of generalized pustular psoriasis such as impetigo herpetiformis. Inverse psoriasis (also known as flexural psoriasis) appears as smooth, inflamed patches of skin. Topical therapies such as corticosteroids, vitamin D analogs, and tazarotene are useful for treating mild to moderate psoriasis. Management of psoriasis must be individualized and may involve combinations of different medications and phototherapy. Atypical forms include guttate, pustular, erythrodermic, and inverse psoriasis. Inverse psoriasis is less scaly than the plaque form and occurs in skin folds such as flexor surfaces and perineal, inframammary, axillary, inguinal, and intergluteal areas (Figure 2). Afebrile (except in pustular or erythrodermic psoriasis, in which the patient may have high fever). Guttate psoriasis: Presents predominantly on the trunk; frequently appears suddenly, 2-3 weeks after an upper respiratory tract infection with group A beta-hemolytic streptococci; this variant is more likely to itch, sometimes severely. Inverse psoriasis: Occurs on the flexural surfaces, armpit, and groin; under the breast; and in the skin folds; this is often misdiagnosed as a fungal infection. Fungal studies: Especially important in cases of hand and foot psoriasis that seem to be worsening with the use of topical steroids or to determine if psoriatic nails are also infected with fungus.

Other presentations, such as guttate, pustular, erythrodermic, inverse, and nail psoriasis also occur () 2Psoriasis is a chronic, inflammatory disease affecting 1-3 of the world’s population. Flexural (inverse, intertriginous) psoriasis manifests with lesions thinner than those of plaque form with no or minimal scaling, and is localized in the skin folds. Pustular and erythrodermic psoriasis are the most severe clinical variants. Fatigue, myalgia, shortness of breath, fever and chills may also occur. More specifically, the clinical spectrum of psoriasis includes the plaque, guttate, small plaque, inverse, erythrodermic, and pustular variants. The prevalence of psoriasis is low in certain ethnic groups such as the Japanese, and may be absent in aboriginal Australians2 and Indians from South America. As noted, an association between psoriasis and other loci has also been reported on chromosomes 1p (PSORS7),14 1q (PSORS4),16 3q (PSORS5),17 4q (PSORS3),18 17q (PSORS2),19 and 19p (PSORS6). (pustular psoriasis) and generalised erythema and scale (erythrodermic psoriasis). Classically, guttate psoriasis occurs shortly after an acute group B haemolytic streptococcal infection of the pharynx or tonsils and can be the presenting episode of psoriasis in children or, occasionally, adults. Flexural (inverse) psoriasis.

Rare life-threatening presentations can occur that require intensive inpatient management. Pustular psoriasis; Inverse psoriasis; Nail psoriasis; Erythrodermic psoriasis. Guttate psoriasis appears in small red spots on the skin. Scaling also occurs. Special types include nail psoriasis, pustular psoriasis (localized to palms and soles, or generalized), psoriatic erythroderma, inverse psoriasis and various forms of palmo-plantar involvement. The skin around an affected nail is sometimes inflamed, and the nail may peel away from the nail bed. Generalized pustular psoriasis is also known as Von Zumbusch pustular psoriasis. Inverse psoriasis occurs in the armpits and groin, under the breasts, and in other areas where skin flexes or folds. There are also guttate, erythrodermic (exfoliative), and pustular forms. adj., adj psoriat ic.

Clinical Presentation Of Psoriasis

The burden of autoimmune disease: a comparison of prevalence ratios in patients with psoriatic arthritis and psoriasis 3Psoriasis is associated with a range of other conditions, such as psoriatic arthritis, coronary artery disease and inflammatory bowel disease. The types of psoriasis include psoriasis vulgaris, flexural/inverse psoriasis, guttate psoriasis, erythrodermic psoriasis, generalised pustular psoriasis, palmoplantar psoriasis, scalp psoriasis and nail psoriasis. Psoriasis vulgaris (also known as chronic plaque psoriasis) is characterised by raised, rough plaques with surrounding normal skin. Flexural (inverse) psoriasis is a rare form of psoriasis that occurs in areas where two layers of skin come together, such as the groin, armpits, buttocks and below the breast. The other presentations that do not fit under pustular or non pustular classifications are grouped under the others category. Psoriatic erythroderma is usually the exacerbation of unstable plaque psoriasis, particularly following abrupt withdrawal of systemic treatment. It is commonly localized but a generalized variant may also occur. Inverse psoriasis (scrotal area). Nail psoriasis is characterized by various nail changes such as changes in nail shape, discoloration, presence of pits or holes, lines across the nails, thickening of the skin under the nail, or in severe cases detachment of the nail from the nail bed.

Psoriasis