Psoriasis history and symptoms: Difference between revisions
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==History== | ==History== | ||
==Symptoms== | === Age of onset === | ||
* Psoriasis can first appear at any age; however, a bimodal distribution of the age of onset is usually seen. | |||
* The first peak for the development of psoriasis occurs during the second decade of life and the second peak is between 40 years to 65 years of life. | |||
=== Family History === | |||
* Patients with early disease onset often have a positive family history of psoriasis, frequent association with histocompatibility antigen (HLA)- Cw6, and more severe disease. Those with onset after the age of 40 usually have a negative family history and a normal frequency of the HLA- Cw6 allele. | |||
=== Initial Presentation === | |||
* A typical patient of psoriasis will present with a history of a long-term erythematous scaly area with ocular and joint involvement depending upon the clinical subtype and chronicity of the disease. There may be multiple relapses and remissions. | |||
=== Past Medical History === | |||
* Past medical history of the patient may include viral or bacterial infection, diabetes, hypertension, chronic kidney disease and/or obesity due to association of psoriasis with these conditions. | |||
=== Social History === | |||
* Social history of the patient may indicate smoking, excessive alcohol consumption and/or a recent stressful event if life associated with an acute exacerbation of psoriasis. | |||
== Symptoms == | |||
=== Common Symptoms<ref name="pmid20107724">{{cite journal |vauthors=Ljosaa TM, Rustoen T, Mörk C, Stubhaug A, Miaskowski C, Paul SM, Wahl AK |title=Skin pain and discomfort in psoriasis: an exploratory study of symptom prevalence and characteristics |journal=Acta Derm. Venereol. |volume=90 |issue=1 |pages=39–45 |year=2010 |pmid=20107724 |doi=10.2340/00015555-0764 |url=}}</ref> === | |||
Common symptoms of psoriasis may include the following: | |||
* A long-term history of erythematous scaly area, which may involve multiple areas of the body. | |||
* Sudden onset of many small areas of scaly redness. | |||
* Recent streptococcal throat infection, viral infection, immunization, use of antimalarial drug, or trauma. | |||
* Pain, which has been described by patients as unpleasant, superficial, sensitive, itchy, hot or burning (especially in erythrodermic psoriasis and in some cases of traumatized plaques or in the joints affected by psoriatic arthritis). | |||
* Pruritus (especially in eruptive, guttate psoriasis). | |||
* High fever in erythrodermic and pustular psoriasis. | |||
* Dystrophic nails. | |||
* Long-term rash with recent presentation of arthralgia. | |||
* Arthralgia without any visible skin findings. | |||
* Ocular symptoms include redness and tearing due to conjunctivitis or blepharitis. | |||
* Avoidance of situations requiring social interaction. | |||
=== Less Common Symptoms<ref name="urlPsoriasis: epidemiology, natural history, and differential diagnosis | PTT">{{cite web |url=https://www.dovepress.com/psoriasis-epidemiology-natural-history-and-differential-diagnosis-peer-reviewed-article-PTT |title=Psoriasis: epidemiology, natural history, and differential diagnosis | PTT |format= |work= |accessdate=}}</ref> === | |||
* Enthesitis | |||
* Depression leading to: | |||
** Insomnia | |||
** Decreased appetite | |||
** Guilt | |||
** Loss of energy | |||
** Decreased concentration | |||
* Dactylitis | |||
* Geographic tongue ( The dorsal surface may have sharply demarcated gyrate red patches with a white to yellow border that may evolve giving the appearence of a map) | |||
==References== | ==References== | ||
Revision as of 18:17, 15 June 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Age of onset
- Psoriasis can first appear at any age; however, a bimodal distribution of the age of onset is usually seen.
- The first peak for the development of psoriasis occurs during the second decade of life and the second peak is between 40 years to 65 years of life.
Family History
- Patients with early disease onset often have a positive family history of psoriasis, frequent association with histocompatibility antigen (HLA)- Cw6, and more severe disease. Those with onset after the age of 40 usually have a negative family history and a normal frequency of the HLA- Cw6 allele.
Initial Presentation
- A typical patient of psoriasis will present with a history of a long-term erythematous scaly area with ocular and joint involvement depending upon the clinical subtype and chronicity of the disease. There may be multiple relapses and remissions.
Past Medical History
- Past medical history of the patient may include viral or bacterial infection, diabetes, hypertension, chronic kidney disease and/or obesity due to association of psoriasis with these conditions.
Social History
- Social history of the patient may indicate smoking, excessive alcohol consumption and/or a recent stressful event if life associated with an acute exacerbation of psoriasis.
Symptoms
Common Symptoms[1]
Common symptoms of psoriasis may include the following:
- A long-term history of erythematous scaly area, which may involve multiple areas of the body.
- Sudden onset of many small areas of scaly redness.
- Recent streptococcal throat infection, viral infection, immunization, use of antimalarial drug, or trauma.
- Pain, which has been described by patients as unpleasant, superficial, sensitive, itchy, hot or burning (especially in erythrodermic psoriasis and in some cases of traumatized plaques or in the joints affected by psoriatic arthritis).
- Pruritus (especially in eruptive, guttate psoriasis).
- High fever in erythrodermic and pustular psoriasis.
- Dystrophic nails.
- Long-term rash with recent presentation of arthralgia.
- Arthralgia without any visible skin findings.
- Ocular symptoms include redness and tearing due to conjunctivitis or blepharitis.
- Avoidance of situations requiring social interaction.
Less Common Symptoms[2]
- Enthesitis
- Depression leading to:
- Insomnia
- Decreased appetite
- Guilt
- Loss of energy
- Decreased concentration
- Dactylitis
- Geographic tongue ( The dorsal surface may have sharply demarcated gyrate red patches with a white to yellow border that may evolve giving the appearence of a map)
References
- ↑ Ljosaa TM, Rustoen T, Mörk C, Stubhaug A, Miaskowski C, Paul SM, Wahl AK (2010). "Skin pain and discomfort in psoriasis: an exploratory study of symptom prevalence and characteristics". Acta Derm. Venereol. 90 (1): 39–45. doi:10.2340/00015555-0764. PMID 20107724.
- ↑ "Psoriasis: epidemiology, natural history, and differential diagnosis | PTT".