Psoriasis: Introduction FeedbackA general introduction to Psoriasis.Source: Clinical Knowledge Summaries, 01 Dec 2012
Psoriasis is characterized by scaly skin lesions, which can be in the form of patches, papules, or plaques. Itch is often a feature.
The skin lesions of psoriasis are characterized by:
Hyperproliferation of the epidermis.
Dilatation and proliferation of blood vessels in the dermis.
Accumulation of inflammatory cells, particularly neutrophils and T-lymphocytes.
Chronic plaque psoriasis (including scalp psoriasis, flexural psoriasis, and facial psoriasis) is the most common form, affecting 80–90% of people with psoriasis. The second most common form is localized pustular psoriasis of the palms and soles.
Other forms of psoriasis include:
Generalized pustular psoriasis.
Psoriasis is common. Around 1–3% of the world's population has psoriasis, with the prevalence varying among ethnic groups.
Several factors are believed to affect the onset or exacerbation of psoriasis, including:
Streptococcal infection — strongly associated with guttate psoriasis.
Sunlight — usually beneficial, but may sometimes exacerbate psoriasis.
Trauma — various types of trauma to previously uninvolved skin can be followed 7–14 days later by the development of psoriasis. This phenomenon is known as the 'Koebner reaction'.
Excessive alcohol intake.
Psoriasis is associated with several other conditions including psoriatic arthritis and inflammatory bowel disease (particularly Crohn's disease).
Psychosocial effects of psoriasis are common, can be profound, and are not necessarily related to the severity of skin involvement.
The diagnosis of psoriasis is usually based on clinical findings. Features suggesting psoriasis include:
Distribution — psoriasis can occur on extensor surfaces (elbows and knees), the trunk, and flexor surfaces (including genital areas).
Size and shape of lesions. There is usually a clear delineation between normal and abnormal (affected) skin.
Colour — may be pink or red, but in people with darker skin this may not be obvious. Scale is typically silvery in colour.
Involvement of other areas — such as the joints or nails.
Topical preparations such as emollients, topical corticosteroids, and vitamin D preparations are the mainstay of treatment in primay care.
Additional treatments in secondary care with systemic drugs, such as methotrexate or light treatment, may be necessary.
Refer for same-day specialist assessment and treatment anyone with erythrodermic psoriasis and generalised pustular psoriasis, these are medical emergencies and require same-day specialist assessment and treatment.
Refer the person for dermatology specialist advice if:
Diagnostic uncertainty exists.
Psoriasis is extensive, for example more than 10% of the body surface area is affected.
Psoriasis is severe as measured by the Physician's Global Assessment.
Topical treatments have failed.
The person cannot tolerate the treatment options available in primary care.
There is a significant impact on physical, psychological or social well being.
Further information or education is needed (for example about application of topical treatments).
Refer to a rheumatologist if the person requires assessment for the management of associated arthropathy.
Assess the severity and impact of psoriasis before referral.
Psoriasis: Guidance FeedbackThe most relevant search results for Psoriasis from producers of guidance information.
- British Society for Rheumatology, 01 January 2012
Guideline 121: Diagnosis and management of psoriasis and psoriatic arthritis in adults - Full guideline [PDF]Scottish Intercollegiate Guidelines Network, 01 October 2010
- Clinical Knowledge Summaries, 01 December 2012
- National Institute for Health and Care Excellence, 01 October 2012
British Association of Dermatologists' guidelines for biologic interventions for psoriasis 2009 [PDF]British Association of Dermatologists, 19 October 2009
Psoriasis: Commissioning FeedbackThe most relevant search results for Psoriasis from producers of commissioning advice.
- National Institute for Health and Care Excellence, 06 August 2013
- National Institute for Health and Care Excellence, 01 August 2013
Information for the public
Psoriasis: Information for the public FeedbackThe most relevant search results for Psoriasis, from Department of Health accredited producers of patient information.
Psoriasis: Medicines FeedbackAppropriate medicines information for Psoriasis supplied by Datapharm, a leading source of trusted, credible information about medicines.
Psoriasis - Medicines Information
- Allantoin/Coal tar extract/Hydrocortisone (a generic version of Alphosyl HC)
- Alphosyl 2 in 1 shampoo
- Alphosyl HC
- Arava (a brand of Leflunomide)
- Betacap (a brand of Betamethasone Valerate)
- Betamethasone dipropionate (a generic version of Diprosone)
- Betamethasone dipropionate/Calcipotriol hydrate (a generic version of Dovobet)
- Betamethasone dipropionate/Calcipotriol monohydrate (a generic version of Xamiol)
- Betamethasone dipropionate/Salicylic acid (a generic version of Diprosalic)
- Betamethasone Valerate
- Bettamousse (a brand of Betamethasone Valerate)
- Calcijex (a brand of Calcitriol)
- Calcipotriol (a generic version of Dovonex)
- Calcipotriol hydrate (a generic version of Dovonex Cream)
- Capasal shampoo
- Carbo-Dome cream
- Clarelux (a brand of Clobetasol Propionate)
- Clobetasol propionate
- Coal tar bath additive (a generic version of Psoriderm Bath Additive)
- Coal tar cream (a generic version of Carbo-Dome Cream)
- Coal tar lotion (a generic version of Exorex Lotion)
- Coal tar shampoo
- Coal tar/Lecithin (a generic version of Psoriderm Cream)
- Coal tar/Salicylic acid/Dithranol
- Coconut oil/Salicylic acid/Coal tar distilled (a generic version of Capasal Shampoo)
- Dithrocream (a brand of Dithranol)
- Doublebase bath additive
- Doublebase gel
- Doublebase shower gel
- Doublebase wash gel
- Dovonex cream
- Exorex lotion
- Generic Meted shampoo (a generic version of Meted Shampoo)
- Generic Polytar AF liquid (a generic version of Polytar AF Liquid)
- Generic Polytar emollient (a generic version of Polytar Emollient)
- Generic Polytar liquid (a generic version of Polytar Liquid)
- Generic Polytar Plus liquid (a generic version of Polytar Plus Liquid)
- Glycerol cream (a generic version of Eumocream)
- Glycerol skin wash
- Glycerol/White soft paraffin/Liquid paraffin
- Golimumab (a generic version of Simponi)
- Humira (a brand of Adalimumab)
- Hydrocortisone butyrate
- Isopropyl myristate/Liquid paraffin (a generic version of Doublebase Gel)
- Liquid paraffin
- Locoid (a brand of Hydrocortisone Butyrate)
- Maxtrex (a brand of Methotrexate)
- Meted (a brand of Sulphur , a brand of Salicylic Acid)
- Meted Shampoo
- Methotrexate sodium
- Mometasone furoate (a generic version of Asmanex , a generic version of Elocon , a generic version of Nasonex)
- Neoral (a brand of Ciclosporin)
- Neotigason (a brand of Acitretin)
- Neutrogena Norwegian Formula cream
- Neutrogena T-Gel shampoo
- Pentrax shampoo
- Phenylethyl alcohol/Undecenoic acid/Cetrimide
- Polytar AF liquid
- Polytar emollient
- Polytar liquid
- Polytar Plus liquid
- Psoriderm bath additive
- Psoriderm cream
- Psoriderm scalp lotion
- Salicylic acid ointment
- Salicylic acid/Coal tar/Sulphur
- Salicylic acid/Dithranol
- Silkis (a brand of Calcitriol)
- Sulphur/salicylic acid
- Ustekinumab (a generic version of Stelara)
- Zorac (a brand of Tazarotene)
- Results are currently sorted by relevance (Sort results by: date)
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... Twitter Facebook Email More... Psoriasis Psoriasis D011565Psoriasis Skin and nail 2012-12-01Last revised in September 2014 Psoriasis - Summary Psoriasis is characterized by scaly...
Clinical Knowledge Summaries, 01 December 2012
Guideline 121: Diagnosis and management of psoriasis and psoriatic arthritis in adults - Full guideline
Diagnosis and management of psoriasis and psoriatic arthritis in adults...Network Diagnosis and management of psoriasis and psoriatic arthritis in adults...2010 Diagnosis anD ManageMent of Psoriasis anD Psoriatic arthritis in aDults...
Scottish Intercollegiate Guidelines Network, 01 October 2010
Introduction Psoriasis is an inflammatory skin disease that typically...relapsing and remitting course. The prevalence of psoriasis is estimated to be around 1.3–2.2%  in the UK. Psoriasis can occur at any age, although is uncommon...
National Institute for Health and Care Excellence, 01 October 2012
...guidelines for biologic interventions for psoriasis 2009 C.H. Smith, A.V. Anstey,* J...Centre, Manchester M6 8HD, U.K. §Psoriasis and Psoriatic Arthritis Alliance, PO Box 111...etanercept, guideline, infliximab, psoriasis, ustekinumab Conflicts of interest...
British Association of Dermatologists, 19 October 2009
...treatment option for adults with plaque psoriasis when the following criteria are met...disease is severe, as defined by a total Psoriasis Area Severity Index (PASI) score of...DLQI) score of more than 10. The psoriasis has not responded to standard systemic...
National Institute for Health and Care Excellence, 01 September 2009
...treatment option for adults with plaque psoriasis for whom anti-tumour necrosis factor...disease is severe as defined by a total Psoriasis Area Severity Index (PASI) of 10 or...Index (DLQI) of more than 10. The psoriasis has not responded to standard systemic...
National Institute for Health and Care Excellence, 01 June 2008
National Institute for Health and Care Excellence, 23 October 2012 - Publication type: Pathway, Guidance
... Send Email Close Show sections Psoriasis: The assessment and management of psoriasis Download Share Share Linked In...CG153] Published date: October 2012 Psoriasis Next This clinical guideline (published...
24 October 2012 - Publisher: NICE - Publication type: Guideline
...treatment of adults with moderate to severe psoriasis Download Share Share Linked...Published date: September 2009 Psoriasis Next Ustekinumab is recommended...possible treatment for people with plaque psoriasis if: standard assessments show that...
23 September 2009 - Publisher: NICE - Publication type: Guideline
...this content Interventions for nail psoriasis Anna Christa Q de Vries 1 , Nathalie...M, Spuls PI. Interventions for nail psoriasis. Cochrane Database of Systematic Reviews...terms Description of the condition Psoriasis is a common chronic skin disease with...
Cochrane Database of Systematic Reviews, 31 January 2013 - Publisher: John Wiley & Sons, Ltd
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