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Papulosquamous Skin Eruptions

»	Name the papulosquamous skin eruptions.
»	What is psoriasis?
»	What is its incidence of psoriasis?
»	List the different types of psoriasis.
»	What is guttate psoriasis?
»	Does pustular psoriasis refer to psoriasis that is secondarily infected?
»	What is inverse psoriasis?
»	Is there a genetic basis for psoriasis?
»	If one of my relatives has psoriasis, what is the chance that I will get psoriasis?
»	Name the types of psoriatic arthritis.
»	Describe the clinical features of the psoriatic arthritides.
»	What are the abnormal nail findings seen in psoriasis? Which is most common?
»	Are there other nonskin manifestations of psoriasis?
»	You are working in a dermatology clinic, seeing a patient with a rash that is possibly psoriasis. Outside the room, the attending asks if you noticed any evidence of the “Koebner phenomenon” or an “Auspitz sign” when you examined the patient. What are these?
»	Name three types of drugs that precipitate or exacerbate psoriasis.
»	What other factors can provoke or exacerbate psoriasis?
»	Do systemic corticosteroids help psoriasis?
»	What topical medications are used to treat psoriasis?
»	How is ultraviolet radiation used to treat psoriasis?
»	What systemic drugs are used to treat psoriasis?
»	What biologic agents may be used in the treatment of psoriasis?
»	Describe the rash of pityriasis rubra pilaris.
»	Although pityriasis rubra pilaris can occur at any age, in what decades is it most often seen? What is the prognosis?
»	How is pityriasis rubra pilaris treated?
»	Describe the distribution of the “seborrheic areas.”
»	What does seborrheic dermatitis look like?
»	What causes seborrheic dermatitis?
»	How can you differentiate between seborrheic dermatitis and psoriasis of the scalp?
»	How is seborrheic dermatitis treated?
»	What is pityriasis rosea? Describe the characteristic rash.
»	What is the cause of pityriasis rosea?
»	In the dermatology clinic, a 20-year-old man presents who has been referred from the primary care clinic with a diagnosis of pityriasis rosea. He has a rash that looks like pityriasis rosea, but he complains of fevers, myalgias, and swollen lymph glands. He remembers having an ulcer on his penis several months ago. What test do you recommend?
»	What are the two major types of parapsoriasis? Why is it important to differentiate between them?
»	What is pityriasis lichenoides et varioliformis acuta?
»	How is PLEVA treated?

What is inverse psoriasis?

A, Guttate, or the acute type of psoriasis, showing widespread droplike lesions. This type of psoriasis is associated with streptococcal infections, probably through the immune-stimulating effects of exotoxins secreted by the bacteria. B, Inverse psoriasis involves intertriginous areas such as the axilla, as shown here. Note the lack of silvery scale seen in psoriasis vulgaris.

Fig. 7.2 A, Guttate, or the acute type of psoriasis, showing widespread droplike lesions. This type of psoriasis is associated with streptococcal infections, probably through the immune-stimulating effects of exotoxins secreted by the bacteria. B, Inverse psoriasis involves intertriginous areas such as the axilla, as shown here. Note the lack of silvery scale seen in psoriasis vulgaris.

Inverse psoriasis refers to psoriasis that involves intertriginous areas (axillae, groin, umbilicus). This distribution is opposite to the usual extensor distribution of psoriasis vulgaris. Psoriatic lesions with both distributions sometimes can be found in the same patients. Clinically, psoriatic lesions found in these “inverse” distributions often do not have scale, but consist of sharply demarcated red plaques that may become macerated and eroded (Fig. 7-2B). Treatment of inverse psoriasis usually involves low-potency (nonfluorinated) topical corticosteroids.