Psoriasis

L40.0-5/L40.8-9

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

Inflammatory condition of the skin and joints of unknown aetiology.
Scaly itchy plaques occur especially on the extensor surfaces of the knees, elbows, sacrum and scalp.
Psoriasis may spread to involve any other sites, although the face is usually spared.
The nails and skin folds are often involved.
Often aggravated by stress and may be provoked by HIV disease.

GENERAL MEASURES

• Counselling regarding precipitating factors and chronicity.
• HIV test, if acute onset and risk factors present.
• Encourage sun exposure as tolerated.

MEDICINE TREATMENT

For flares (if delay experienced in obtaining a dermatological consultation):

• Coal tar (Liquor picis carbonis (LPC) BP 5%, topical.

OR

• Corticosteroid, potent, topical, e.g.:
• Betamethasone 0.1%, topical, apply 12 hourly (Doctor prescribed ).
  • Decrease according to severity, reduce to hydrocortisone 1%, topical, and then stop.

REFERRAL

All patients, if diagnosis is not already confirmed.
Complications such as pustular psoriasis, acute flares, chronic local plaques.