Internal Medicine

(Wang) #1

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:19


Psoriasis 1237

➣May present as pits, onycholysis, or hyperkeratotic debris under
the nail
➣May correlate with arthritis in nearby joints
■Arthritis
➣May occur as the major manifestation of psoriasis, or as a second
major illness with major or minor skin involvement. Roughly 30%
of patients with psoriasis have or will develop psoriatic arthritis.
Most often the skin disease is present prior to the onset and diag-
nosis of psoriatic arthritis.

tests
■Basic Blood Tests: N/A
■Specific Diagnostic Tests
➣Histopathology is helpful in differentiating other disorders, but
when the disease is clinically atypical the histology is often atyp-
ical
■Other Tests as Appropriate
➣Joint x-rays for those with arthralgias or arthritis
differential diagnosis
■Chronic Plaque Psoriasis
➣Lichen planus
➣Eczema
➣Mycosis fungoides
➣Tinea corporis
■Inverse Psoriasis
➣Candida Intertrigo
➣Tinea cruris/corporis
➣Benign familial pemphigus
➣Contact dermatitis
■Guttate psoriasis
➣Pityriasis rosea
➣Pityriasis lichenoides et varioliformis acuta
➣Syphilis
➣Tinea corporis
■Pustular psoriasis
➣Infection
■Erythrodermic psoriasis
➣Dermatitis
➣Cutaneous T-cell lymphoma (Sezary syndrome)
➣Drug eruption
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