J Clin Outcomes Manage
A red, scaly rash: how to recognize and treat psoriasis
Cayce KA, Carroll CL, Pearce DJ, Feldman SR
Abstract Objective: To review the diagnosis and treatment of psoriasis. Methods: Qualitative assessment of the literature. Results: Psoriasis is a common, chronic cutaneous disorder distinguished by erythematous, scaling plaques characteristically distributed in the scalp and the extensor surfaces of the elbows and knees. Inflammation and hyperproliferation are key findings along with associated symptoms of pruritus, pain, and in 10% to 30% of patients, a form of arthritis. Psoriasis has negative effects on quality of life as great as those seen with other major medical disorders. The pathogenesis of psoriasis is considered to be multifactorial with a known genetic predisposition; evidence for the prominent role of T cells recently has emerged. Treatment modalities include topical, oral, or injectable medications and phototherapy or lasers. Localized disease usually can be controlled with topical medications and can easily be managed by primary care providers. For patients with generalized disease or those with associated psoriatic arthritis, evaluation and management by a dermatologist is recommended. All patients with psoriasis (and the physicians who care for them) should be encouraged to use the resources of the National Psoriasis Foundation (www.psoriasis.org) to help address both psychosocial and educational issues. Conclusion: Patients with psoriasis are likely to present in the primary care setting. Physicians should be able to recognize psoriasis and manage localized disease.
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