PsoriasisTreatmentand DDx

Treatment

Explanation and reassurance

TopicalTreatment

Vitamin D analogue

CalcipotriolTacalcitol

mild to moderatepsoriasis

retinoids Tazarotene

corticosteroids

‘limitedchoice’ areas

face, ears,genitalsandflexures

patients who cannot usevitamin D analogues

unresponsivepsoriasis

scalp,palms andsoles

minor localized psoriasis

Salicylic acid short periods

Dithranol

Coal tar

UVS/E

Acute PhototoxicitySkin cancer

Systemic

When Severephotochemotherapy

retinoids Acitretin

methotrexate Liver failure

ciclosporin S/ERenal failureHTN

hydroxyurea

Sulfasalazine

never use systemic steroids for psoriasis

Combinedresistant cases

Differentialdiagnosis

Discoideczema

less well defined

exudative or crusted

lack thick scalesDon't favor extensor surfaces

Seborrhoeiceczema

more diffuse

less lumpyoverflowing the scalpmargins and interspersedwith normal skin in psoriasis

not so sharply marginated

Sitesear, face, eyebrows

Pityriasisrosea

confused with guttate psoriasislesions are oval

run along rib lines

Christmas treeScaling is ofcollarette type

herald plaqueconfined to the upper trunk

2ndry syphilis

Cutaneous t­cell lymphoma

Tineaunguium

more asymmetrical

obvious tinea of neighboring skinPitting is not seen

Nails are crumbly and discoloured

3/12/2011 ­ Maen K. Abu Househ | Reviewed by Reem Al­qudah ­  Psoriasis Treatment and DDx