You are evaluating a patient with a chronic rash who comes in for treatment. The patient is a 28-year-old man who complains of chronically pruritic skin with scaly, plaque-like eruptions on the knees, gluteal cleft, and scalp. He has also noticed “potholes” in his fingernails bilaterally. On review of systems, he also notes early-morning back pain, which improves with movement, and intense dandruff. The scalp lesions have significantly limited his quality of life due to the constant scaling. He has no other past medical history and has never been treated for this before. When considering possible treatment regimens for this disorder, all of the following may be considered except (LQ)
|E||UV light therapy|
1). Psoriasis is a common chronic inflammatory skin disease.
2). It is characterized by erythematous, sharply demarcated papules and rounded plaques covered by a silvery scale.
3). The lesions are highly pruritic.
4). Traumatized areas often develop lesions (Koebner phenomenon). Infections, stress, and medications may exacerbate psoriasis.
5). Fingernail lesions such as pitting, onycholysis, or nail thickening or subungual hyperkeratosis are present in 50% of patients.
6). Topical treatment options for psoriasis include mid-potency glucocorticoids, vitamin D analogues, retinoids, and ultraviolet light.
7). Systemic therapy is reserved for severe or widespread disease.
8). Oral glucocorticoids should not be used for the treatment of psoriasis due to the life-threatening risk of developing pustular psoriasis when therapy is discontinued. Systemic therapies approved by the U.S.
9). Food and Drug Administration include methotrexate, retinoids, calcineurin inhibitors, and biologic agents (anti-tumor necrosis factor, anti-CD11a, anti-CD2).