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PSORIASIS IDENTIFICATION AND MANAGEMENT. How can psoriasis present? Plaques Flexural Guttate Scalp Hands and feet nails.

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Presentation on theme: "PSORIASIS IDENTIFICATION AND MANAGEMENT. How can psoriasis present? Plaques Flexural Guttate Scalp Hands and feet nails."— Presentation transcript:

1 PSORIASIS IDENTIFICATION AND MANAGEMENT

2 How can psoriasis present? Plaques Flexural Guttate Scalp Hands and feet nails

3 Plaque psoriasis

4 Guttate psoriasis

5 Flexural psoriasis

6 Scalp psoriasis

7 Nail psoriasis

8 Hand and foot psoriasis

9 Management- Plaques Depends on amount of body surface affected. Consider psychological impact and discuss Emollient Topical vitamin d analogue +/- moderately potent topical steroid short term. Caution regarding Dovobet Exorex for small multiple plaques review

10 Plaque continued Dithranol an option if motivated and able to apply correctly Limited response- consider UVB Systemic therapy- Methotrexate / Neotigason Biological agents

11 Guttate psoriasis May occur after a streptococcal throat infection Often resolves after a few weeks Topical tar e.g. Exorex Mild topical steroid Consider referral for UVB if not improving

12 Flexural Psoriasis Often treated as thrush- look for clues Milder vitamin d analogue( tacalcitol / calcitriol). Topical steroid ( clobetasone butyrate) Reduce frequency when settled to maintain control

13 Scalp psoriasis Challenging and requires dedication Psoriasis association advice sheet explains how to apply treatments. Mild - tar based shampoo used twice a week Moderate - above+ calcipotriol or betamethasone scalp application 2-3 times a week Severe – salicylic acid/ coal tar applied and left on overnight, comb out, wash then apply steroid/ vitamin d application.

14 Scalp contd Maintain with 1-2 x a week vitamin d analogue or weakest topical steroid that will control + tar based shampoo.

15 Nail psoriasis Exclude fungal infection- clippings Nothing works topically. Nail varnish for women

16 Hands and feet Can be a challenge. Emollient – thicker and possibly urea based Salicylic acid to soften scale Potent topical steroid – ointment/ occlusion Vitamin d analogues bit impractical as need to apply a thick layer Refer for PUVA and possibly systemic treatment

17 Pustular psoriasis Does not mean infection

18 Useful sources of information


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