PSORIASIS

This is an inflammatory condition of the skin and joints of unknown aetiology. Scaly red, itchy papules and plaques over extensor surfaces and in the scalp are common. The nails and skin folds are often involved. In exceptional cases, it is localised to palms and soles and pustular skin lesions are seen especially following rapid treatment withdrawal, e.g. steroids or systemic agents.

GENERAL MEASURES

Counselling regarding precipitating factors and chronicity.

Encourage sun exposure as tolerated.

MEDICINE TREATMENT

Local plaques

• Coal tar 6% ointment, topical, apply at night.
  • Avoid use on the face, flexures and genitalia.

For flares:

• Betamethasone 0.1%, topical, apply 12 hourly.
  • Decrease according to severity, reduce to hydrocortisone 1%, then stop.

Scalp psoriasis

For maintenance:

• Coal tar 1% ointment, topical, apply at night.

For flares

• Betamethasone1% lotion, topical, apply once daily.

REFERRAL

»      No response to treatment.

»      Severe disease.