Psoriasis

Complications

• physical    - pruritus, fissuring, bleeding of lesions
• systemic   - in generalized pustular or erythrodermic psoriasis:
                    - fever, weight loss
                    - congestive heart failure (due to increased cutaneous blood flow)
                    - fluid/electrolyte imbalance
                    - hypoalbuminemia, low iron, hyperuricemia
• emotional/psychological
                    - patients with psoriasis often feel stigmatized and socially isolated
                    - loss of self-esteem
• economic
                    - costs of medication
                    - time away from work
 • Psoriatic arthritis: 5-10% of patients with psoriasis will have psoriatic arthritis;
                       seronegative (RF), association with HLA-B27
                    - asymmetric peripheral joint involvement (most common)
                    - symmetric peripheral joint involvement (resembles rheumatoid arthritis)
                    - axial disease (resembles ankylosing spondylitis)
                    - arthritis mutilans (uncommon) 

     

     

     

     

     

     

     Psoriasis
      - Clinical:
          - key features
          - sites of predilection
          - variants of psoriasis
                 - guttate psoriasis
                 - inverse psoriasis
                 - pustular psoriasis
                 - erythrodermic psoriasis
      - Pathogenesis:
          - koebner phenomenon
      - Complications
      - Treatment
      - Micropathology