Psoriasis physical examination: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 3: | Line 3: | ||
==Overview== | ==Overview== | ||
Common physical examination findings of | Common physical examination findings of psoriasis include [[erythematous]], scaling [[papules]] and [[plaques]]. | ||
==Physical Examination== | ==Physical Examination== | ||
| Line 13: | Line 13: | ||
*[[Tachycardia]] with regular pulse<ref name="pmid12677433">{{cite journal |vauthors=Iizuka H, Takahashi H, Ishida-Yamamoto A |title=Pathophysiology of generalized pustular psoriasis |journal=Arch. Dermatol. Res. |volume=295 Suppl 1 |issue= |pages=S55–9 |year=2003 |pmid=12677433 |doi=10.1007/s00403-002-0372-5 |url= |issn=}}</ref> | *[[Tachycardia]] with regular pulse<ref name="pmid12677433">{{cite journal |vauthors=Iizuka H, Takahashi H, Ishida-Yamamoto A |title=Pathophysiology of generalized pustular psoriasis |journal=Arch. Dermatol. Res. |volume=295 Suppl 1 |issue= |pages=S55–9 |year=2003 |pmid=12677433 |doi=10.1007/s00403-002-0372-5 |url= |issn=}}</ref> | ||
*[[Tachypnea]] | *[[Tachypnea]] | ||
* | *Kussmaul respirations may be present in patients with comorbid [[diabetes]] and [[DKA]] | ||
===Skin=== | ===Skin=== | ||
* A [[diagnosis]] of psoriasis is usually based on the [[skin]] appearance | * A [[diagnosis]] of psoriasis is usually based on the [[skin]] appearance | ||
| Line 21: | Line 20: | ||
* [[Papulosquamous disorder|Papulosquamous]] [[disease]] with variable morphology, distribution, severity, and course | * [[Papulosquamous disorder|Papulosquamous]] [[disease]] with variable morphology, distribution, severity, and course | ||
* | * Scaly [[Papule|papules]] and [[Plaque|plaques]] | ||
*[[Koebner phenomenon]]: Appearance of new psoriatic [[lesions]] at the site of skin injury | *[[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]] | *Woronoff’s ring: Ring of peripheral blanching skin around a psoriatic [[plaque]] | ||
| Line 46: | Line 45: | ||
*[[Sensorineural hearing loss]] associated with [[psoriatic arthritis]] | *[[Sensorineural hearing loss]] associated with [[psoriatic arthritis]] | ||
*[[Rinne test]] may be negative (abnormal) | *[[Rinne test]] may be negative (abnormal) | ||
*[[Weber test]] may show a quieter sound in the ear with the | *[[Weber test]] may show a quieter sound in the ear with the [[sensorineural hearing loss]] | ||
===Neck=== | ===Neck=== | ||
*[[Lymphadenopathy|Cervical lymphadenopathy]] | *[[Lymphadenopathy|Cervical lymphadenopathy]] | ||
| Line 54: | Line 53: | ||
*Bilateral decreased breath sounds | *Bilateral decreased breath sounds | ||
*Bilateral wheezes | *Bilateral wheezes | ||
*Reduced [[tactile fremitus]] | *Reduced [[tactile fremitus]] | ||
===Heart=== | ===Heart=== | ||
*The risk of arterial and venous vascular diseases (e.g. [[myocardial infarction]], [[thrombophlebitis]], [[Pulmonary embolism|pulmonary embolization]]) is higher in severe psoriasis involving multiple areas of the body<ref name="pmid17433490">{{cite journal |vauthors=Kremers HM, McEvoy MT, Dann FJ, Gabriel SE |title=Heart disease in psoriasis |journal=J. Am. Acad. Dermatol. |volume=57 |issue=2 |pages=347–54 |year=2007 |pmid=17433490 |doi=10.1016/j.jaad.2007.02.007 |url=}}</ref> | *The risk of arterial and venous vascular diseases (e.g. [[myocardial infarction]], [[thrombophlebitis]], [[Pulmonary embolism|pulmonary embolization]]) is higher in severe psoriasis involving multiple areas of the body.<ref name="pmid17433490">{{cite journal |vauthors=Kremers HM, McEvoy MT, Dann FJ, Gabriel SE |title=Heart disease in psoriasis |journal=J. Am. Acad. Dermatol. |volume=57 |issue=2 |pages=347–54 |year=2007 |pmid=17433490 |doi=10.1016/j.jaad.2007.02.007 |url=}}</ref> | ||
*There may be a chance of getting [[high output cardiac failure]] to [[erythroderma]]<ref name="pmid17433490">{{cite journal |vauthors=Kremers HM, McEvoy MT, Dann FJ, Gabriel SE |title=Heart disease in psoriasis |journal=J. Am. Acad. Dermatol. |volume=57 |issue=2 |pages=347–54 |year=2007 |pmid=17433490 |doi=10.1016/j.jaad.2007.02.007 |url=}}</ref> | *There may be a chance of getting [[high output cardiac failure]] due to [[erythroderma]].<ref name="pmid17433490">{{cite journal |vauthors=Kremers HM, McEvoy MT, Dann FJ, Gabriel SE |title=Heart disease in psoriasis |journal=J. Am. Acad. Dermatol. |volume=57 |issue=2 |pages=347–54 |year=2007 |pmid=17433490 |doi=10.1016/j.jaad.2007.02.007 |url=}}</ref> | ||
=== Abdomen === | === Abdomen === | ||
Revision as of 16:50, 7 August 2017
|
Psoriasis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Psoriasis physical examination On the Web |
|
American Roentgen Ray Society Images of Psoriasis physical examination |
|
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 psoriasis include erythematous, scaling papules and plaques.
Physical Examination
Appearance of the Patient
- Patient may look distressed and anxious
Vital signs
- High-grade fever with generalized pustular psoriasis[1]
- Tachycardia with regular pulse[1]
- Tachypnea
- Kussmaul respirations may be present in patients with comorbid diabetes and DKA
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
Extremities
Trunk
Face
Nail Psoriasis
Inverse Psoriasis
HEENT
- Scalp psoriasis may show raised, reddish, often scaly patches
- Ophthalmoscopic exam in psoriasis may show uveitis, more frequently in patients with arthropathy or pustular psoriasis[2]
- 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
Neck
Lungs
- Psoriasis has been known to be associated with COPD[3]
- Expanded/barrel shaped chest because of COPD
- Bilateral decreased breath sounds
- Bilateral wheezes
- Reduced tactile fremitus
Heart
- 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.[4]
- There may be a chance of getting high output cardiac failure due to erythroderma.[4]
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.
- ↑ 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.
- ↑ 4.0 4.1 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.