J Clin Outcomes Manage
A red, scaly rash: how to recognize and treat psoriasis
Martin SL, Dabade TS, Feldman ST
Abstract: Objective: To review the diagnosis, pathophysiology, associated comorbidities, and treatment of psoriasis. Methods: Case presentation and qualitative literature review. Results: Psoriasis is a chronic, multisystem auto-immune disease. Up-regulation of the immune system, primarily Th1 and Th17 responses, causes cutaneous manifestations and places the patient at increased risk for cardiovascular, metabolic, and autoimmune comorbidities. Skin disease is characterized by erythematous, scaling plaques that cause pain and pruritus. Psoriasis impairs physical, mental, and social functioning and decreases the quality of life for patients and close companions. Physicians should be aware of these psychosocial issues and encourage patients to join the National Psoriasis Foundation to gain access to educational and supportive resources. Treatment is guided by objective disease findings and subjective patient preference. For localized disease, topical therapies or localized phototherapy can be used. With more generalized disease, phototherapy, systemic medications, and biologics used alone or in combination are options. Referral to a specialist may be warranted. Conclusion: Psoriasis is a common disease likely to present in the primary care setting. Physicians should be familiar with the clinical presentation and aware of the comorbidities and psychosocial issues that accompany a diagnosis. Coordination of care between primary physicians and specialists is important due to the multi-systemic nature of the disease and the wide variety of treatment options. Patient education and support are equally essential.
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