dermatologic disorders
Psoriasis
Key Points
Psoriasis is a common inflammatory disorder affecting the skin that has a genetic component and several triggers (eg, trauma, infection, certain medications). The most common skin findings are usually well-circumscribed, erythematous papules and plaques covered with silvery scales in plaque psoriasis, but lesions differ between the other less common subtypes of psoriasis. Psoriatic arthritis develops in 5 to 30% of patients and can cause joint destruction and disability. Diagnose based on the appearance and distribution of lesions. Consider topical treatments (eg, emollients,salicylic acid,coal tarpreparations,anthralin, corticosteroids, vitamin D3 analogs, calcineurin inhibitors, PDE-4 inhibitors,tapinarof,tazarotene), particularly for mild disease. For moderate to severe psoriasis, consider systemic treatments such as retinoids,methotrexate,cyclosporine, biologics (eg, TNF inhibitors), and small molecules (eg,deucravacitinib). Ultraviolet (UV) light therapy may be an alternative for patients who resist systemic immunosuppression. 