plaque type psoriasis

Psoriasis

aggrevating factor

• physical trauma

• infection , 1-2 week after infection

• medication , NSAID, beta blocker , ACEI,chloroquine, gemfibrosil , lithium , interferon

• stress

type

• plaque type psoriasis : well- circumcribe erythematous plaque with silvery scale usually at extensor area

• guttate psoriasis : small < 1 cm salmon pink papule with or without scale , mainly at trunk , happen 2-3 week after URI may be associate with strep infection

• pustular psoriasis: sterile pustules appearing on the palms and soles or diffusely over the body.

• erythrodermic psoriasis : generalized erythema, pain, itching, and fine scaling

• inverse psoriasis : smooth inflame lesion without scaling

psoriatic nail

• pitting nail

• Oil spot

• Subungual hyperkeratosis

• Onycholysis

• Onychodystrophy

psoriatic arthritis classification

treatment

lesion < 20 % BSA => topical

topical medication

• topical steroid : tape off ID => od

• tar preparation : not associate with CA , LCD

• vitamin D : calciprotriol or calciprotriol plus steroid

• calcineurin inhibitor : tarcolimus , pimercolimus od or bid , suitable for face

• salicylic acid , increase absorbtion of other drug , make scale thinner

oral medication

MTX

• short term bone marrow suppression

• cirrhosis

narrow band UVB

PUVA