Advertisement

Clinical Reviews in Allergy & Immunology

, Volume 44, Issue 2, pp 166–172 | Cite as

Clinical and Histologic Diagnostic Guidelines for Psoriasis: A Critical Review

  • Mary Ann N. Johnson
  • April W. Armstrong
Article

Abstract

Psoriasis is a common inflammatory skin disease that is associated with joint, psychiatric, and cardiovascular comorbidities. Diagnosis of plaque psoriasis is dependent primarily on characteristic physical findings and history. Given the varied clinical presentations of psoriasis and its mimicry to other papulosquamous skin diseases, it may be difficult for nondermatologists to diagnose psoriasis. Currently, no diagnostic criteria for plaque psoriasis have been validated in clinical studies. In this paper, we provide diagnostic guidelines for the nondermatologist to aid them in recognizing psoriasis.

Keywords

Psoriasis Diagnosis Histopathology Diagnostic criteria 

References

  1. 1.
    Koo J (1996) Population-based epidemiologic study of psoriasis with emphasis on quality of life assessment. Dermatol Clin 14:485–496PubMedCrossRefGoogle Scholar
  2. 2.
    Kurd SK, Gelfand JM (2009) The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003–2004. J Am Acad Dermatol 60:218–224PubMedCrossRefGoogle Scholar
  3. 3.
    Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T (2004) Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc 9:136–139PubMedCrossRefGoogle Scholar
  4. 4.
    Hauber AB, Gonzalez JM, Schenkel B, Lofland JH, Martin S (2011) The value to patients of reducing lesion severity in plaque psoriasis. J Dermatolog Treat 22:266–275PubMedCrossRefGoogle Scholar
  5. 5.
    Varni JW, Globe DR, Gandra SR, Harrison DJ, Hooper M, Baumgartner S (2011) Health-related quality of life of pediatric patients with moderate to severe plaque psoriasis: comparisons to four common chronic diseases. Eur J Pediatr. doi: 10.1007/s00431-011-1587-2
  6. 6.
    Lin TY, See LC, Shen YM, Liang CY, Chang HN, Lin YK (2011) Quality of life in patients with psoriasis in northern Taiwan. Chang Gung Med J 34:186–196PubMedGoogle Scholar
  7. 7.
    Henseler T, Christophers E (1985) Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris. J Am Acad Dermatol 13:450–456PubMedCrossRefGoogle Scholar
  8. 8.
    Han C, Lofland JH, Zhao N, Schenkel B (2011) Increased prevalence of psychiatric disorders and health care-associated costs among patients with moderate-to-severe psoriasis. J Drugs Dermatol 10:843–850PubMedGoogle Scholar
  9. 9.
    Fortune DG, Richards HL, Griffiths CE (2005) Psychologic factors in psoriasis: consequences, mechanisms, and interventions. Dermatol Clin 23:681–694PubMedCrossRefGoogle Scholar
  10. 10.
    Griffiths CE, Barker JN (2007) Pathogenesis and clinical features of psoriasis. J Lancet 370:263–271CrossRefGoogle Scholar
  11. 11.
    Dominguez PL, Assarpour A, Kuo H, Holt EW, Tyler S, Qureshi AA (2009) Development and pilot-testing of a psoriasis screening tool. Br J Dermatol 161:778–784PubMedCrossRefGoogle Scholar
  12. 12.
    Ross CM (1966) Skin disease in the Venda. S Afr Med J 40:302–308PubMedGoogle Scholar
  13. 13.
    Schafer T (2006) Epidemiology of psoriasis. Review and the German perspective. J Dermatol 212:327–337CrossRefGoogle Scholar
  14. 14.
    Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ (2005) Prevalence and treatment of psoriasis in the United Kingdom: a population-based study. Arch Dermatol 141:1537–1541PubMedCrossRefGoogle Scholar
  15. 15.
    Eckes L, Ananthakrishnan R, Walter H (1975) The geographic distribution of psoriasis. Hautarzt 26:563–567PubMedGoogle Scholar
  16. 16.
    Shrank AB (1965) A field survey in Nigeria. Trans St Johns Hosp Dermatol Soc 51:85–94PubMedGoogle Scholar
  17. 17.
    Farber EM, Nall L (1998) Epidemiology: natural history and genetics. In: Roenigk HH, Maibach HI (eds) Psoriasis. Dekker, New York, pp 107–157Google Scholar
  18. 18.
    Gelfand JM, Stern RS, Nijsten T et al (2005) The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol 52:23–26PubMedCrossRefGoogle Scholar
  19. 19.
    Chang YT, Chen TJ, Liu PC et al (2009) Epidemiological study of psoriasis in the national health insurance database in Taiwan. Acta Derm Venereol 89:262–266PubMedCrossRefGoogle Scholar
  20. 20.
    Yip SY (1984) The prevalence of psoriasis in the Mongoloid race. J Am Acad Dermatol 10:965–968PubMedCrossRefGoogle Scholar
  21. 21.
    Fry L (1988) Psoriasis. Br J Dermatol 119:445–461PubMedCrossRefGoogle Scholar
  22. 22.
    Papp K, Valenzuela F, Poulin Y, Bernstein G, Wasel N (2010) Epidemiology of moderate-to-severe plaque psoriasis in a Canadian surveyed population. J Cutan Med Surg 14:167–174PubMedGoogle Scholar
  23. 23.
    Manjula VD, Sreekiran S, Saril PS, Sreekanth MP (2011) A study of psoriasis and quality of life in a tertiary care teaching hospital of kottayam, kerala. Indian J Dermatol 56:403–406PubMedCrossRefGoogle Scholar
  24. 24.
    Ganemo A, Wahlgren CF, Svensson A (2011) Quality of life and clinical features in Swedish children with psoriasis. Pediatr Dermatol 28:375–379PubMedCrossRefGoogle Scholar
  25. 25.
    Ayala F (2007) Clinical presentation of psoriasis. Reumatismo 59(Suppl 1):40–45PubMedGoogle Scholar
  26. 26.
    Zhang X, Wang H, Te-Shao H, Yang S, Chen S (2002) The genetic epidemiology of psoriasis vulgaris in Chinese Han. Int J Dermatol 41:663–669PubMedCrossRefGoogle Scholar
  27. 27.
    Elder JT, Nair RP, Henseler T et al (2001) The genetics of psoriasis 2001: the odyssey continues. Arch Dermatol 137:1447–1454PubMedGoogle Scholar
  28. 28.
    Andressen C, Henseler T (1982) Inheritance of psoriasis. Analysis of 2035 family histories. Hautarzt 33:214–217PubMedGoogle Scholar
  29. 29.
    Ikaheimo I, Tiilikainen A, Karvonen J, Silvennoinen-Kassinen S (1996) HLA risk haplotype Cw6, DR7, DQA1*0201 and HLA-Cw6 with reference to the clinical picture of psoriasis vulgaris. Arch Dermatol Res 288:363–365PubMedCrossRefGoogle Scholar
  30. 30.
    Suomela S, Kainu K, Onkamo P et al (2007) Clinical associations of the risk alleles of HLA-Cw6 and CCHCR1*WWCC in psoriasis. Acta Derm Venereol 87:127–134PubMedCrossRefGoogle Scholar
  31. 31.
    Luszczek W, Kubicka W, Cislo M et al (2003) Strong association of HLA-Cw6 allele with juvenile psoriasis in Polish patients. Immunol Lett 85:59–64PubMedCrossRefGoogle Scholar
  32. 32.
    Nevitt GJ, Hutchinson PE (1996) Psoriasis in the community: prevalence, severity and patients’ beliefs and attitudes towards the disease. Br J Dermatol 135:533–537PubMedCrossRefGoogle Scholar
  33. 33.
    Raychaudhuri SP, Gross J (2000) A comparative study of pediatric onset psoriasis with adult onset psoriasis. Pediatr Dermatol 17:174–178PubMedCrossRefGoogle Scholar
  34. 34.
    Gudjonsson JE, Thorarinsson AM, Sigurgeirsson B, Kristinsson KG, Valdimarsson H (2003) Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study. Br J Dermatol 149:530–534PubMedCrossRefGoogle Scholar
  35. 35.
    Armstrong AW, Armstrong EJ, Fuller EN, Sockolov ME, Voyles SV (2011) Smoking and pathogenesis of psoriasis: a review of oxidative, inflammatory, and genetic mechanisms. Br J Dermatol 165(6):1162–1168PubMedCrossRefGoogle Scholar
  36. 36.
    Fortes C, Mastroeni S, Leffondre K et al (2005) Relationship between smoking and the clinical severity of psoriasis. J Arch Dermatol 141:1580–1584CrossRefGoogle Scholar
  37. 37.
    Cassano N, Vestita M, Apruzzi D, Vena GA (2011) Alcohol, psoriasis, liver disease, and anti-psoriasis drugs. Int J Dermatol 50:1323–1331PubMedCrossRefGoogle Scholar
  38. 38.
    Farkas A, Kemeny L (2010) Psoriasis and alcohol: is cutaneous ethanol one of the missing links? Br J Dermatol 162:711–716PubMedCrossRefGoogle Scholar
  39. 39.
    Qureshi AA, Dominguez PL, Choi HK, Han J, Curhan G (2010) Alcohol intake and risk of incident psoriasis in US women: a prospective study. J Arch Dermatol 146:1364–1369CrossRefGoogle Scholar
  40. 40.
    Sampogna F, Gisondi P, Melchi CF, Amerio P, Girolomoni G, Abeni D (2004) Prevalence of symptoms experienced by patients with different clinical types of psoriasis. Br J Dermatol 151:594–599PubMedCrossRefGoogle Scholar
  41. 41.
    Globe D, Bayliss MS, Harrison DJ (2009) The impact of itch symptoms in psoriasis: results from physician interviews and patient focus groups. J Health Qual Life Outcomes 7:62CrossRefGoogle Scholar
  42. 42.
    Sanchez-Regana M, Sola-Ortigosa J, Alsina-Gibert M, Vidal-Fernandez M, Umbert-Millet P (2011) Nail psoriasis: a retrospective study on the effectiveness of systemic treatments (classical and biological therapy). J Eur Acad Dermatol Venereol 25:579–586PubMedCrossRefGoogle Scholar
  43. 43.
    Reich A, Hrehorow E, Szepietowski JC (2010) Pruritus is an important factor negatively influencing the well-being of psoriatic patients. Acta Derm Venereol 90:257–263PubMedGoogle Scholar
  44. 44.
    O’Neill JL, Chan YH, Rapp SR, Yosipovitch G (2011) Differences in itch characteristics between psoriasis and atopic dermatitis patients: results of a web-based questionnaire. Acta Derm Venereol 91:537–540PubMedGoogle Scholar
  45. 45.
    Reich A, Welz-Kubiak K, Szepietowski JC (2011) Pruritus differences between psoriasis and lichen planus. Acta Derm Venereol 91:605–606PubMedGoogle Scholar
  46. 46.
    Meier M, Sheth PB (2009) Clinical spectrum and severity of psoriasis. Curr Probl Dermatol 38:1–20PubMedCrossRefGoogle Scholar
  47. 47.
    Armesto S, Esteve A, Coto-Segura P et al (2011) Nail psoriasis in individuals with psoriasis vulgaris: a study of 661 patients. Actas Dermosifiliogr 102:365–372PubMedCrossRefGoogle Scholar
  48. 48.
    Woo SM, Choi JW, Yoon HS, Jo SJ, Youn JI (2008) Classification of facial psoriasis based on the distributions of facial lesions. J Am Acad Dermatol 58:959–963PubMedCrossRefGoogle Scholar
  49. 49.
    van de Kerkhof PC, Steegers-Theunissen RP, Kuipers MV (1998) Evaluation of topical drug treatment in psoriasis. J Dermatol 197:31–36CrossRefGoogle Scholar
  50. 50.
    Mrowietz U, Macheleidt O, Eicke C (2011) Effective treatment and improvement of quality of life in patients with scalp psoriasis by topical use of calcipotriol/betamethasone (Xamiol® -gel): results. J Dtsch Dermatol Ges 9:825–831PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of California DavisSacramentoUSA

Personalised recommendations