Fast Five Quiz: Psoriasis

William James, MD

Disclosures

November 08, 2021

Although patients with psoriasis can present at any age, bimodal peaks are noted at age 15-30 years and age 50-60 years. Signs, symptoms, and etiologic factors in patients presenting with psoriasis may include the following:

  • Worsening of a long-term erythematous scaly area

  • Sudden onset of many small areas of scaly redness

  • Recent streptococcal throat infection, viral infection, immunization, use of antimalarial drug, or trauma

  • Family history of similar skin condition

  • Pain (especially in erythrodermic psoriasis, and sometimes in traumatized plaques or in the joints affected by psoriatic arthritis)

  • Pruritus (especially in eruptive, guttate psoriasis)

  • Fever in pustular or erythrodermic psoriasis

  • Nail changes (including pitting, oil spots, subungual hyperkeratosis, nail dystrophy, and onycholysis)

  • Long-term rash with recent presentation of joint pain

  • Joint pain without any visible skin findings

The skin almost always is affected before the eyes. Ocular findings occur in approximately 10% of patients. The most common ocular symptoms are redness and tearing due to conjunctivitis or blepharitis. Nonocular symptoms are related to rash and psoriatic arthritis. The rash can be uncomfortable or even painful. Fissured tongue is the most common oral psoriasis finding and is present in 6.5%-20% of individuals with psoriasis that affects the skin.

Read more about the presentation of psoriasis.

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