Psoriasis – Different Types

Transcript

“There are definitely different types of psoriasis. Variants include chronic plaque psoriasis, guttate psoriasis, linear psoriasis, erythrodermic psoriasis and pustular psoriasis. Psoriasis vulgaris is another term for plaque psoriasis and is a Latin medical term for this disorder. Chronic plaque psoriasis presents as typical lesions with wall demarcated, erythematous plaques with silvery scales. Often symmetrical lesions on the elbows and knees occur. And sometimes it involves additional sites, including the scalp, pre-state grown, hands, feet inter-gluteal folds and umbilicus. Lesions can be surrounded by a peripheral blanching ring known as Woronoff’s ring, particularly when a patient is receiving phototherapy or light treatment. Guttate psoriasis has typical lesions that are ranged from small papules to plaques, from three millimeters to 1.5 centimeters in size with adherence scaling. The distribution is generalized, and it tends to affect children more than adults. It’s often preceded by a respiratory infection.

In children, they may have spontaneous remission, however, it often responds to UVB phototherapy. The differential diagnosis includes syphilis, pityriasis rosea, in reaction to tinea pedis and a small plaque parapsoriasis. In linear psoriasis. It often presents as linear erythematous and scaly lesions that often follow lines of blaschko. Differential diagnosis of linear psoriasis includes inflammatory linear verrugous epidermal nevi, ILVEN, which often follow the lines of blaschko and are resistant to therapy. Epidermal nevus with superimposed psoriasis. In erythrodermic psoriasis, there’s generalized erythema, or redness of the skin with areas of scaling. It can be acute or gradual in onset. There are nail changes, spearing of the face and a history of typical plaque type psoriasis, which may be helpful clues. It may be seen after abrupt tapering of medications, particularly steroids.

The differential diagnosis of erythrodermic psoriasis includes other causes of erythroderma, including pityriasis rubra pilaris, generalized atopic dermatitis and Cezary syndrome. In pustular psoriasis, there may sometimes be a generalized pustular psoriasis in the [?] pattern. It presents as redness or erythema and sterile pustules that are not infectious, arising with an erythematous and painful skin. With characteristic lakes of pus and associated fever. Trigger factors include pregnancy, where it is known as impetigo herpetiformis, rapid tapering of corticosteroids, hypocalcemia and infections. The differential diagnosis includes acute generalized exanthematous pustulosis agea and pustular drug reactions. Palmoplantar pustulosis often presents as sterile pustules on the palms and soles. The patient may actually have no evidence of psoriasis elsewhere on the body. Triggers include infections, stress, and the condition may actually be aggravated by smoking. Occasionally pustular psoriasis may be associated with inflammatory lesions in the bone. The pattern may sometimes be annular. And the differential diagnosis of this condition includes Sneddon Wilkinson disease. Trigger factors include infections and stress. There’s also an exanthematant type with significant overlap with age. Localized patterns of disease of pustular psoriasis can occur within plaques and often due to errogens. Acrodermatitis continua of hallopeau is another variant that can present with erythema and scaling of distal digits with pustules and often an associated fever.”