Psoriasis physical examination: Difference between revisions
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===Lungs=== | ===Lungs=== | ||
*Psoriasis has been known to be associated with [[COPD]].<ref name="pmid18637897">{{cite journal |vauthors=Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen AD |title=Psoriasis and chronic obstructive pulmonary disease: a case-control study |journal=Br. J. Dermatol. |volume=159 |issue=4 |pages=956–60 |year=2008 |pmid=18637897 |doi=10.1111/j.1365-2133.2008.08749.x |url=}}</ref> | *Psoriasis has been known to be associated with [[COPD]].<ref name="pmid18637897">{{cite journal |vauthors=Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen AD |title=Psoriasis and chronic obstructive pulmonary disease: a case-control study |journal=Br. J. Dermatol. |volume=159 |issue=4 |pages=956–60 |year=2008 |pmid=18637897 |doi=10.1111/j.1365-2133.2008.08749.x |url=}}</ref> | ||
* | *Expanded/barrel shaped chest because of [[COPD]]. | ||
*Bilateral | *Bilateral decreased breath sounds. | ||
*Bilateral wheezes. | *Bilateral wheezes. | ||
*[[Egophony]] absent. | *[[Egophony]] absent. | ||
Revision as of 20:00, 31 July 2017
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Psoriasis Microchapters |
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Diagnosis |
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Psoriasis physical examination On the Web |
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American Roentgen Ray Society Images of Psoriasis physical examination |
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Risk calculators and risk factors for Psoriasis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2] Kiran Singh, M.D. [3]
Overview
Common physical examination findings of psoraisis include erythematous, scaling papules and plaques on the skin.
Physical Examination
Appearance of the Patient
- Patient with psoriasis may look distressed and anxious.
Vital signs
- High-grade fever with generalized pustular psoriasis.[1]
- Tachycardia with regular pulse.[1]
- Tachypnea.
- Kussmal respirations may be present in patients with comorbid diabetes and DKA.
- High-output cardiac failure in erythroderma.[2]
Skin
- A diagnosis of psoriasis is usually based on the appearance of the skin. There are no special blood tests or diagnostic procedures for psoriasis. Sometimes a skin biopsy, or scraping, may be needed to rule out other disorders and to confirm the diagnosis. Skin from a biopsy will show clubbed rete pegs if positive for psoriasis.
- Psoriasis is a papulosquamous disease with variable morphology, distribution, severity, and course.
- It is characterized by scaling 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
Extremities
Trunk
Face
Nail Psoriasis
Inverse Psoriasis
HEENT
- Scalp psoriasis may cause raised, reddish, often scaly patches.
- Ophthalmoscopic exam in psoriasis may show uveitis, more frequently in patients with arthropathy or pustular psoriasis.[3]
- 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 sensorineuronal hearing loss.
Neck
Lungs
- Psoriasis has been known to be associated with COPD.[4]
- Expanded/barrel shaped chest because of COPD.
- Bilateral decreased breath sounds.
- Bilateral wheezes.
- Egophony absent.
- Reduced tactile fremitus.
Heart
- The risk of arterial and venous vascular diseases (eg, myocardial infarction, thrombophlebitis, pulmonary embolization) is higher in sever psoriasis involving multiple areas of the body.[5]
- There may be a chance of getting high output cardiac failure to erytheroderma.[5]
Abdomen
- No abdominal distention.
- No abdominal tenderness.
- No Hepatomegaly/splenomegaly/hepatosplenomegaly.
References
- ↑ 1.0 1.1 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.
- ↑ FOX RH, SHUSTER S, WILLIAMS R, MARKS J, GOLDSMITH R, CONDON RE (1965). "CARDIOVASCULAR, METABOLIC, AND THERMOREGULATORY DISTURBANCES IN PATIENTS WITH ERYTHRODERMIC SKIN DISEASES". Br Med J. 1 (5435): 619–22. PMC 2165960. PMID 14245176.
- ↑ 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.
- ↑ 5.0 5.1 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.