Skip to main content
SpringerLink
Log in

Psoriasis

  • Chapter
  • First Online:
Common Dermatologic Conditions in Primary Care

Part of the book series: Current Clinical Practice ((CCP))

  • 690 Accesses

Abstract

Primary care physicians may be the first points of contact for patients presenting with signs and symptoms of psoriasis, an inflammatory skin disorder that classically appears as scaly plaques but may take a variety of forms and be associated with arthropathy and various chronic extra-cutaneous conditions. A growing body of literature on therapeutic approaches highlights topical regimens, phototherapy, established systemic immune-modulating medications, and increasingly, newer biologic agents and small molecule inhibitors for individuals with refractory and/or severe disease. Efficient diagnosis and timely initiation of treatment by primary care providers, alone or in conjunction with dermatologic specialists, may help attenuate the significant impact that psoriasis may have on patients’ quality of life and healthcare costs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Moller AH, Erntoft S, Vinding GR, et al. A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values. Patient Relat Outcome Meas. 2015;6:167–77.

    PubMed  PubMed Central  Google Scholar 

  2. Yu AP, Tang J, Xie J, et al. Economic burden of psoriasis compared to the general population and stratified by disease severity. Curr Med Res Opin. 2009;25(10):2429–38.

    PubMed  Google Scholar 

  3. WHO. Global report on psoriasis. 2016. http://apps.who.int/iris/bitstream/10665/204417/1/9789241565189_eng.pdf?ua=1. Accessed 2 Jan 2017.

  4. Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol. 2017;31(2):205–12.

    CAS  PubMed  Google Scholar 

  5. Tollefson MM, Crowson CS, McEvoy MT, et al. Incidence of psoriasis in children: a population based study. J Am Acad Dermatol. 2010;62:979–84.

    PubMed  Google Scholar 

  6. Augustin M, Glaeske G, Radtke MA, et al. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol. 2010;162:633–40.

    CAS  PubMed  Google Scholar 

  7. Parisi R, Symmons DP, Griffiths CE, et al. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133:377–81.

    CAS  PubMed  Google Scholar 

  8. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70:512–9.

    PubMed  Google Scholar 

  9. Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(suppl 2):ii18–23.

    PubMed  PubMed Central  Google Scholar 

  10. Mahil SK, Capon F, Barker JN. Genetics of psoriasis. Dermatol Clin. 2015;33:1–8.

    CAS  PubMed  Google Scholar 

  11. Mahil SK, Capon F, Barker JN. Update on psoriasis immunopathogenesis and targeted immunotherapy. Semin Immunopathol. 2016;38:11–27.

    CAS  PubMed  Google Scholar 

  12. Eberle FC, Bruck J, Holstein J, et al. Recent advances in understanding psoriasis. F1000Research. 2016;5:770–8.

    Google Scholar 

  13. Maruani A, Samimi M, Stembridge N, et al. Interventions for guttate psoriasis. Cochrane Database Syst Rev. 2015;(2). Art. No.: CD011541. https://doi.org/10.1002/14651858.CD011541.

  14. Asumalahti K, Ameen M, Suomela S, et al. Genetic analysis of PSORS1 distinguishes guttate psoriasis and palmoplantar pustulosis. J Invest Dermatol. 2003;120(4):627–32.

    CAS  PubMed  Google Scholar 

  15. Cai Y, Fleming C, Yan J. New insights of T cells in the pathogenesis of psoriasis. Cell Mol Immunol. 2012;9(4):302–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Yan KX, Fang X, Han L, et al. Foxp3+ regulatory T cells and related cytokines differentially expressed in plaque vs. guttate psoriasis vulgaris. Br J Dermatol. 2010;163(1):48–56.

    CAS  PubMed  Google Scholar 

  17. Mallbris L, Larsson P, Bergqvist S, et al. Psoriasis phenotype at disease onset: clinical characterization of 400 adult cases. J Invest Dermatol. 2005;124(3):499–504.

    CAS  PubMed  Google Scholar 

  18. Zhao G, Feng X, Na A, et al. Acute guttate psoriasis patients have positive streptococcus hemolyticus throat cultures and elevated antistreptococcal M6 protein titers. J Dermatol. 2005;32(2):91–6.

    CAS  PubMed  Google Scholar 

  19. Totte JE, van der Feltz WT, Bode LG, et al. A systematic review and meta-analysis on Staphylococcus aureus carriage in psoriasis, acne and rosacea. Eur J Clin Microbiol Infect Dis. 2016;35(7):1069–77.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–71.

    CAS  Google Scholar 

  21. Levine D, Gottlieb A. Evaluation and management of psoriasis: an internist’s guide. Med Clin North Am. 2009;93(6):1291–303.

    CAS  PubMed  Google Scholar 

  22. Jiaravuthisan MM, Sasseville D, Vender RB, et al. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J Am Acad Dermatol. 2007;57(1):1–27.

    PubMed  Google Scholar 

  23. Klaassen KM, van de Kerkhof PC, Pasch MC. Nail psoriasis, the unknown burden of disease. J Eur Acad Dermatol Venereol. 2014;28(12):1690–5.

    CAS  PubMed  Google Scholar 

  24. Langenbruch A, Radtke MA, Krensel M, et al. Nail involvement as a predictor of concomitant psoriatic arthritis in patients with psoriasis. Br J Dermatol. 2014;171(5):1123–8.

    CAS  PubMed  Google Scholar 

  25. Pasch MC. Nail psoriasis: a review of treatment options. Drugs. 2016;76(6):675–705.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Rosenbach M, Hsu S, Korman NJ, et al. Treatment of erythrodermic psoriasis: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010;62:655–62.

    CAS  PubMed  Google Scholar 

  27. Long CC, Finlay AY, Averill RW. The rule of hand: 4 hand areas = sFTU = 1 g. Arch Dermatol. 1992;128:1129–30.

    CAS  PubMed  Google Scholar 

  28. Nagel T, Schunk J. Using the hand to estimate to estimate the surface area of a burn in children. Pediatr Emerg Care. 1997;13:254–5.

    CAS  PubMed  Google Scholar 

  29. Meier M, Sheth PB. Clinical spectrum and severity of psoriasis. Curr Probl Dermatol. 2009;38:1–20.

    PubMed  Google Scholar 

  30. PAsitraining.com. PASI online calculator. http://www.pasitraining.com/calculator/step_1.php. Accessed 3 Jan 2017.

  31. Schmitt J, Kuster D. Correlation between Dermatology Life Quality Index (DLQI) scores and Work Limitations Questionnaire (WLQ) allows the calculation of percent work productivity loss in patients with psoriasis. Arch Dermatol Res. 2015;307(5):451–3.

    PubMed  Google Scholar 

  32. Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs. 2014;74(4):423–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(2):242–8.

    PubMed  Google Scholar 

  34. Villani AP, Rouzaud M, Sevrain M, et al. Symptoms dermatologists should look for in daily practice to improve detection of psoriatic arthritis in psoriasis patients: an expert group consensus. J Eur Acad Dermatol Venereol. 2014;5:27–32.

    Google Scholar 

  35. Ciocon DH, Kimball AB. Psoriasis and psoriatic arthritis: separate or one and the same? Br J Dermatol. 2007;157(5):850–60.

    CAS  PubMed  Google Scholar 

  36. Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665–73.

    PubMed  Google Scholar 

  37. Fleming P, Kraft J, Gulliver WP, et al. The relationship of obesity with the severity of psoriasis: a systematic review. J Cutan Med Surg. 2015;19(5):450–6.

    PubMed  Google Scholar 

  38. Kimball AB, Gladman D, Gelfand JM, et al. National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol. 2008;58(6):1031–42.

    PubMed  PubMed Central  Google Scholar 

  39. Li X, Kong L, Li F, et al. Association between psoriasis and chronic obstructive pulmonary disease: a systematic review and meta-analysis. PLoS One. 2015;10(12):e0145221. https://doi.org/10.1371/journal.pone.0145221.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Richer V, Roubille C, Fleming P, et al. Psoriasis and smoking: a systemic literature review and meta-analysis with qualitative analysis of effect of smoking on psoriasis severity. J Cutan Med Surg. 2016;20(3):221–7.

    PubMed  Google Scholar 

  41. Bremmer S, Van Voorhees AS, Hsu S, et al. Obesity and psoriasis: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010;63:1058–69.

    PubMed  Google Scholar 

  42. Coto-Segura P, Eiris-Salvado N, Gonzales-Lara L, et al. Psoriasis, psoriatic arthritis and type 2 diabetes mellitus: a systematic review and meta-analysis. Br J Dermatol. 2013;169(4):783–93.

    CAS  PubMed  Google Scholar 

  43. Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc. 2013;2(2):e000062. https://doi.org/10.1161/JAHA.113.000062.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol. 2013;149(1):84–91.

    PubMed  Google Scholar 

  45. Pouplard C, Brenaut E, Horreau C, et al. Risk of cancer in psoriasis: a systematic review and meta-analysis of epidemiological studies. J Eur Acad Dermatol Venereol. 2013;3:36–46.

    Google Scholar 

  46. Meeuwis KA, de Hullu JA, Massuger LF, et al. Genital psoriasis: a systematic literature review on this hidden skin disease. Acta Derm Venereol. 2011;91(1):5–11.

    PubMed  Google Scholar 

  47. Slutsky JB, Clark RA, Remedios AA, et al. An evidence-based review of the efficacy of coal tar preparations in the treatment of psoriasis and atopic dermatitis. J Drugs Dermatol. 2010;9(10):1258–64.

    PubMed  Google Scholar 

  48. Mason A, Mason J, Cork M, et al. Topical treatments for chronic plaque psoriasis: an abridged Cochrane systematic review. J Am Acad Dermatol. 2013;69(5):799–807.

    CAS  PubMed  Google Scholar 

  49. Hendriks AG, Keijers RR, de Jong EM, et al. Efficacy and safety of combinations of first-line topical treatments in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013;27(8):931–51.

    CAS  PubMed  Google Scholar 

  50. Schlager JG, Rosumeck S, Werner RN, et al. Topical treatments for scalp psoriasis. Cochrane Database Syst Rev. 2016;(2):CD009687. https://doi.org/10.1002/14651858.CD009687.

  51. Chen X, Yang M, Cheng Y, et al. Narrow-band ultraviolet B phototherapy versus broad-band ultraviolet B or psoralen-ultraviolet a photochemotherapy for psoriasis. Cochrane Database Syst Rev. 2013;(10):CD009481. https://doi.org/10.1002/14651858.CD009481.

  52. Almutawa F, Thalib L, Hekman D, et al. Efficacy of localized phototherapy and photodynamic therapy for psoriasis: a systematic review and meta-analysis. Photodermatol Photoimmunol Photomed. 2015;31(1):5–14.

    PubMed  Google Scholar 

  53. Ling TC, Clayton TH, Crawley J, et al. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy. Br J Dermatol. 2016;174(1):24–55.

    CAS  PubMed  Google Scholar 

  54. Sevrain M, Richard MA, Barnetche T, et al. Treatment for palmoplantar pustular psoriasis: systematic literature review, evidence-based recommendations and expert opinion. J Eur Acad Dermatol Venereol. 2014;5:13–6.

    Google Scholar 

  55. Maybury CM, Habbar-Lopez ZK, Wong T, et al. Methotrexate and liver fibrosis in people with psoriasis: a systematic review of observational studies. Br J Dermatol. 2014;171(1):17–29.

    CAS  PubMed  Google Scholar 

  56. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(1):451–85.

    CAS  PubMed  Google Scholar 

  57. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis, section 6: guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011;65(1):137–74.

    PubMed  Google Scholar 

  58. Atwan A, Ingram JR, Abbott R, et al. Oral fumaric acid esters for psoriasis: abridged Cochrane systemic review including GRADE assessments. Br J Dermatol. 2016;175(5):873–81.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Balak DM, Fallah Arani S, Hajderbegovic E, et al. Efficacy, effectiveness, and safety of fumaric acid esters in the treatment of psoriasis: a systematic review of randomized and observational studies. Br J Dermatol. 2016;175(2):250–62.

    CAS  PubMed  Google Scholar 

  60. Owen CM, Chalmers RJ, O’Sullivan T, et al. A systematic review of antistreptococcal interventions for guttate and chronic plaque psoriasis. Br J Dermatol. 2001;145(6):886–90.

    CAS  PubMed  Google Scholar 

  61. Dupire G, Droitcourt C, Ferneiny M, Hughes C, Katsahian S, Le Cleach L. Antistreptococcal interventions for guttate and chronic plaque psoriasis. Cochrane Database Syst Rev. 2015;(3). Art. No.: CD011571. https://doi.org/10.1002/14651858.CD011571.

  62. Elyoussfi S, Thomas BJ, Ciurtin C. Tailored treatment options for patients with psoriatic arthritis and psoriasis: review of established and new biologic and small molecule therapies. Rheumatol Int. 2016;36:603–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Sorenson E, Koo J. Evidence-based adverse effects of biologic agents in the treatment of moderate-to-severe psoriasis: providing clarity to an opaque topic. J Dermatolog Treat. 2015;26(6):493–501.

    PubMed  Google Scholar 

  64. Roubille C, Richer V, Starnino T, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74(3):480–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  65. Wang J, Zhan Q, Zhang L. A systematic review on the efficacy and safety of infliximab in patients with psoriasis. Hum Vaccin Immunother. 2016;12(2):431–7.

    PubMed  Google Scholar 

  66. Mauskopf J, Samuel M, McBride D, et al. Treatment sequencing after failure of the first biologic in cost-effectiveness models of psoriasis: a systematic review of published models and clinical practice guidelines. PharmacoEconomics. 2014;32(4):395–409.

    PubMed  PubMed Central  Google Scholar 

  67. Yamauchi PS, Bissonnette R, Teixeira HD, et al. Systematic review of efficacy of anti-tumor necrosis factor (TNF) therapy in patients with psoriasis previously treated with a different anti-TNF agent. J Am Acad Dermatol. 2016;75(3):612–8.

    CAS  PubMed  Google Scholar 

  68. Busard C, Zweegers J, Limpens J, et al. Combined use of systemic agents for psoriasis: a systematic review. JAMA Dermatol. 2014;150(11):1213–20.

    PubMed  Google Scholar 

  69. Farahnik B, Beroukhim K, Nakamura M, et al. Anti-IL-17 agents for psoriasis: a review of phase III data. J Drugs Dermatol. 2016;15(3):311–6.

    CAS  PubMed  Google Scholar 

  70. Talbott W, Duffy N. Complementary and alternative medicine for psoriasis: what the dermatologist needs to know. Am J Clin Dermatol. 2015;16(3):147–65.

    PubMed  Google Scholar 

  71. Napolitano M, Megna M, Balato A. Systemic treatment of pediatric psoriasis: a review. Dermatol Ther (Heidelb). 2016;6(2):125–42.

    Google Scholar 

  72. Van Geel MJ, Mul K, de Jager MR, et al. Systemic treatments in paediatric psoriasis: a systematic evidence-based update. J Eur Acad Dermatol Venereol. 2015;29(3):425–37.

    PubMed  Google Scholar 

  73. Sancemente G, Murphy R, Contreras J, et al. Anti-TNF agents for paediatric psoriasis. Cochrane Database Syst Rev. 2015;(11):CD010017. https://doi.org/10.1002/14651858.CD010017.pub2.

  74. Umar N, Yamamoto S, Loerbroks A, et al. Elicitation and use of patients’ preferences in the treatment of psoriasis: a systematic review. Acta Derm Venereol. 2012;92(4):341–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA

    Seyed Parham Khalili

Authors
  1. Seyed Parham Khalili
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seyed Parham Khalili .

Editor information

Editors and Affiliations

  1. Family Medicine Residency Program, Abington Hospital-Jefferson Health, Jenkintown, PA, USA

    John J. Russell

  2. Bryn Mawr Skin & Cancer Institute, Bryn Mawr, PA, USA

    Edward F. Ryan Jr.

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Khalili, S.P. (2019). Psoriasis. In: Russell, J., Ryan Jr., E. (eds) Common Dermatologic Conditions in Primary Care. Current Clinical Practice. Humana, Cham. https://doi.org/10.1007/978-3-030-18065-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18065-2_14

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-18064-5

  • Online ISBN: 978-3-030-18065-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation