Psoriasis physical examination
|
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 appear 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 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
HEENT
- 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[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 secondary to 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 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.