Psoriasis classification: Difference between revisions
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==Overview== | ==Overview== | ||
Psoriasis can be classified according to clinical appearance, [[Morphology (biology)|morphology]] and localization. According to International Psoriasis Council, psoriasis may be classified into 4 subtypes: plaque-type psoriasis, guttate psoriasis, generalized pustular psoriasis (GPP), [[erythroderma]]. Several further subphenotypes have been named according to distribution (localized vs. widespread), [[anatomical]] localization (flexural- also called inverse, scalp, palms/soles/nail), size (large vs. small) and thickness (thick vs. thin) of [[Plaque|plaques]], onset (early vs. late), and disease activity (active vs. stable). | Psoriasis can be classified according to clinical appearance, [[Morphology (biology)|morphology]] and localization. According to International Psoriasis Council, psoriasis may be classified into 4 subtypes: plaque-type psoriasis, guttate psoriasis, generalized pustular psoriasis (GPP), [[erythroderma]]. Several further subphenotypes have been named according to distribution (localized vs. widespread), [[anatomical]] localization (flexural - also called inverse, [[scalp]], [[Palms of the hands|palms]]/[[soles]]/nail), size (large vs. small) and thickness (thick vs. thin) of [[Plaque|plaques]], onset (early vs. late), and disease activity (active vs. stable). | ||
==Classification== | ==Classification== | ||
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* Small plaques < 3cm | * Small plaques < 3cm | ||
* [[Dorsal|Extensor]] surface of elbows and knees | * [[Dorsal|Extensor]] surface of [[elbows]] and [[knees]] | ||
* Scalp | * [[Scalp]] | ||
* Lower back | * [[Lower back]] | ||
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* [[trunk]] | * [[trunk]] | ||
* Upper extremities | * [[Upper extremities]] | ||
* Thighs | * [[Thighs]] | ||
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* 2–4 weeks after a [[Bacterial|bacterial infection]] of the upper ways, notably [[streptococcal pharyngitis]] in children and adolescents | * 2–4 weeks after a [[Bacterial|bacterial infection]] of the upper ways, notably [[streptococcal pharyngitis]] in children and adolescents | ||
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* Four sub-types namely: | * Four sub-types namely: | ||
** Zumbusch (erythema, sheeted pustulation and scarlatiniform peeling) | ** Zumbusch ([[erythema]], sheeted pustulation and scarlatiniform peeling) | ||
** Annular (gyrate and annular pustular lesions) | ** Annular (gyrate and annular [[Pustular rash|pustular]] [[lesions]]) | ||
** Localized (restricted areas of pustular psoriasis in and around ordinary psoriatic plaques) | ** Localized (restricted areas of pustular psoriasis in and around ordinary psoriatic [[plaques]]) | ||
** Exanthematic (single short-lived episode following infection or drug exposure) | ** Exanthematic (single short-lived episode following [[infection]] or [[drug]] exposure) | ||
* Episodic, widespread skin and systemic [[inflammation]]. | * Episodic, widespread [[skin]] and systemic [[inflammation]]. | ||
* Sheeted, pinhead-sized, sterile, sub-corneal pustules | * Sheeted, pinhead-sized, [[sterile]], sub-corneal [[pustules]] | ||
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|Erythrodermic psoriasis (most severe) | |Erythrodermic psoriasis (most severe) | ||
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* Diffuse erythema | * Diffuse [[erythema]] | ||
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* >70 % of the body surface area | * >70 % of the body surface area | ||
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* Hypothermia | * [[Hypothermia]] | ||
* Extremity [[edema]] | * Extremity [[edema]] | ||
* Myalgias | * [[Myalgias]] | ||
* Fatigue | * [[Fatigue]] | ||
* High grade fever | * [[Fever|High grade fever]] | ||
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Revision as of 17:05, 24 July 2017
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Psoriasis Microchapters |
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Psoriasis classification On the Web |
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American Roentgen Ray Society Images of Psoriasis classification |
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Risk calculators and risk factors for Psoriasis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Psoriasis can be classified according to clinical appearance, morphology and localization. According to International Psoriasis Council, psoriasis may be classified into 4 subtypes: plaque-type psoriasis, guttate psoriasis, generalized pustular psoriasis (GPP), erythroderma. Several further subphenotypes have been named according to distribution (localized vs. widespread), anatomical localization (flexural - also called inverse, scalp, palms/soles/nail), size (large vs. small) and thickness (thick vs. thin) of plaques, onset (early vs. late), and disease activity (active vs. stable).
Classification
Psoriasis can be classified according to clinical appearance, morphology and localization.
- The International Psoriasis Council, classifies psoriasis into four main forms:
- Plaque-type psoriasis
- Guttate psoriasis
- Generalized Pustular Psoriasis (GPP)
- Erythroderma
| Type of Psoriasis | Typical lesion | Body Distribution | Associated conditions |
|---|---|---|---|
| Plaque-type psoriasis (most common) |
|
|
|
| Guttate psoriasis |
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| Generalized pustular psoriasis[1] |
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| |
| Erythrodermic psoriasis (most severe) |
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|
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Several further subphenotypes have been named according to distribution (localized vs. widespread), anatomical localization (flexural- also called inverse, scalp, palms/soles/nail), size (large vs. small) and thickness (thick vs. thin) of plaques, onset (early vs. late), and disease activity (active vs. stable).
Other types of psoriasis
- Flexural psoriasis (inverse psoriasis) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals (between the thigh and groin), axillae, under an overweight stomach (pannus), and under the breasts (inframammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections.
- Nail psoriasis produces a variety of changes in the appearance of finger and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening (onycholysis) and crumbling of the nail.
- Drug-induced psoriasis
- Napkin psoriasis
- Seborrheic-like psoriasis
- Pustular psoriasis
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Photograph of an arm covered with plaque psoriasis. -
Psoriasis nail pitting
Severity
Psoriasis is usually graded as:
- Mild (affecting less than 3% of the body)
- Moderate (affecting 3-10% of the body)
- Severe
Degree of severity
The degree of severity is generally based on the following factors:
- The proportion of body surface area affected
- Disease activity (degree of plaque redness, thickness and scaling)
- Response to previous therapies
- The impact of the disease on the person.
Psoriasis Area Severity Index (PASI)
The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).[2] The PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.[3]
References
- ↑ Baker H, Ryan TJ (1968). "Generalized pustular psoriasis. A clinical and epidemiological study of 104 cases". Br. J. Dermatol. 80 (12): 771–93. PMID 4236712.
- ↑ "Psoriasis Update -Skin & Aging". Retrieved 2007-07-28.
- ↑ Louden BA, Pearce DJ, Lang W, Feldman SR (2004). "A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients". Dermatol. Online J. 10 (2): 7. PMID 15530297.