Psoriasis physical examination
Psoriasis physical examination On the Web
American Roentgen Ray Society Images of Psoriasis physical examination
Appearance of the patient
- Patient may appear distressed and anxious
- High-grade fever with generalized pustular psoriasis
- Tachycardia with regular pulse
- Kussmaul respirations may be present in patients with comorbid diabetes and DKA
- A diagnosis of psoriasis is usually based on the appearance of the skin
- Papulosquamous disease with variable morphology, distribution, severity, and course
- Scaly papules and plaques
- Koebner phenomenon: Appearance of new psoriatic lesions at the site of skin injury
- Woronoff’s ring: Ring of peripheral blanching skin around a psoriatic plaque
- Auspitz’s sign: Small bleeding points seen upon disruption of a psoriatic scale
Scalp psoriasis, courtesy of regionalderm.net
Extremity psoriasis(guttate variety), courtesy of regionalderm.net
Trunk psoriasis, courtesy of regionalderm.net
Face psoriasis, courtesy of https://aloeworldnorfolk.wordpress.com/tag/psoriasis/
Nails showing pitting, crumbling and brittleness, courtesy of http://www.atlasdermatologico.com.br/
Inverse psoriasis, courtesy of regionalderm.net
- Scalp psoriasis may manifest as raised, reddish, often scaly patches
- Ophthalmoscopic exam in psoriasis may show uveitis, most commonly in patients with arthropathy or pustular psoriasis
- Sensorineural hearing loss associated with psoriatic arthritis
- Rinne test may be negative (abnormal)
- Weber test may show a quieter sound in the ear with the sensorineural hearing loss
- Psoriasis has been known to be associated with COPD
- Expanded/barrel shaped chest secondary to COPD
- Bilateral decreased breath sounds
- Bilateral wheezes
- Reduced tactile fremitus
- The risk of arterial and venous vascular diseases (e.g. myocardial infarction, thrombophlebitis, pulmonary embolization) is higher in severe psoriasis involving multiple areas of the body.
- There may be a chance of high output cardiac failure due to erythroderma.
- Iizuka H, Takahashi H, Ishida-Yamamoto A (2003). "Pathophysiology of generalized pustular psoriasis". Arch. Dermatol. Res. 295 Suppl 1: S55–9. doi:10.1007/s00403-002-0372-5. PMID 12677433.
- Fraga NA, Oliveira Mde F, Follador I, Rocha Bde O, Rêgo VR (2012). "Psoriasis and uveitis: a literature review". An Bras Dermatol. 87 (6): 877–83. PMC 3699904. PMID 23197207.
- Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen AD (2008). "Psoriasis and chronic obstructive pulmonary disease: a case-control study". Br. J. Dermatol. 159 (4): 956–60. doi:10.1111/j.1365-2133.2008.08749.x. PMID 18637897.
- Kremers HM, McEvoy MT, Dann FJ, Gabriel SE (2007). "Heart disease in psoriasis". J. Am. Acad. Dermatol. 57 (2): 347–54. doi:10.1016/j.jaad.2007.02.007. PMID 17433490.