Psoriasis physical examination: Difference between revisions

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*Auspitz’s sign: Small [[bleeding]] points seen upon disruption of a psoriatic scale
*Auspitz’s sign: Small [[bleeding]] points seen upon disruption of a psoriatic scale
<gallery>
<gallery>
[[Image:Psoriasis (uv light, steroids, keratolytics).jpg|thumb|400px|left]]
 
<br clear"left"/>
Image:Psoriahair.jpg|200px|left|frame|'''Scalp psoriasis''', courtesy of regionalderm.net
Image:Extremity_psoriasis.jpg|200px|left|frame|'''Extremity psoriasis(guttate variety)''', courtesy of regionalderm.net
Image:Trunkpsor.jpg|200px|left|frame|'''Trunk psoriasis''', courtesy of regionalderm.net
Image:Psoriasis_face.jpg|500px|left|frame|'''Face psoriasis''', courtesy of https://aloeworldnorfolk.wordpress.com/tag/psoriasis/
Image:Nail_psoriasis01.jpg|200px|left|frame|'''Nails showing pitting, crumbling and brittleness''', courtesy of http://www.atlasdermatologico.com.br/
Image:PsoriasisAxilla.jpg|200px|left|frame|'''Inverse psoriasis''', courtesy of regionalderm.net
 
</gallery>
</gallery>
=====Scalp=====
[[Image:Psoriahair.jpg|200px|center|frame|'''Scalp psoriasis''', courtesy regionalderm.net]]
====Extremities====
[[Image:Extremity_psoriasis.jpg|200px|center|frame|'''Extremity psoriasis(guttate variety)''', courtesy regionalderm.net]]
=====Trunk=====
[[Image:Trunkpsor.jpg|200px|center|frame|'''Trunk psoriasis''', courtesy regionalderm.net]]
=====Face=====
[[Image:Psoriasis_face.jpg|500px|center|frame|'''Face psoriasis''', courtesy https://aloeworldnorfolk.wordpress.com/tag/psoriasis/ ]]
=====Nail Psoriasis=====
[[Image:Nail_psoriasis01.jpg|200px|center|frame|'''Nails showing pitting, crumbling and brittleness''', courtesy http://www.atlasdermatologico.com.br/]]
=====Inverse Psoriasis=====
[[Image:PsoriasisAxilla.jpg|200px|center|frame|'''Inverse psoriasis''', courtesy regionalderm.net]]


===HEENT===
===HEENT===
*Scalp psoriasis may show raised, reddish, often scaly patches
*Scalp psoriasis may manifest as raised, reddish, often scaly patches
*Ophthalmoscopic exam in psoriasis may show [[uveitis]], more frequently in patients with [[arthropathy]] or pustular psoriasis<ref name="pmid23197207">{{cite journal |vauthors=Fraga NA, Oliveira Mde F, Follador I, Rocha Bde O, Rêgo VR |title=Psoriasis and uveitis: a literature review |journal=An Bras Dermatol |volume=87 |issue=6 |pages=877–83 |year=2012 |pmid=23197207 |pmc=3699904 |doi= |url= |issn=}}</ref>
*Ophthalmoscopic exam in psoriasis may show [[uveitis]], most commonly in patients with [[arthropathy]] or pustular psoriasis<ref name="pmid23197207">{{cite journal |vauthors=Fraga NA, Oliveira Mde F, Follador I, Rocha Bde O, Rêgo VR |title=Psoriasis and uveitis: a literature review |journal=An Bras Dermatol |volume=87 |issue=6 |pages=877–83 |year=2012 |pmid=23197207 |pmc=3699904 |doi= |url= |issn=}}</ref>
*[[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 [[sensorineural hearing loss]]  
*[[Weber test]] may show a quieter sound in the ear with the [[sensorineural hearing loss]]
 
===Neck===
===Neck===
*[[Lymphadenopathy|Cervical lymphadenopathy]]
*[[Lymphadenopathy|Cervical lymphadenopathy]]
===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]]
*Expanded/barrel shaped chest secondary to [[COPD]]
*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]] 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>
*There may be a chance of [[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 ===
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Primary care]]
[[Category:Dermatology]]
[[Category:Dermatology]]
{{WH}}
{{WS}}

Latest revision as of 23:52, 29 July 2020

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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

Skin

  • A diagnosis of psoriasis is usually based on the appearance of the skin
    • A skin biopsy, or scraping, may be necessary to rule out other disorders and confirm a diagnosis of psoriasis
    • Skin from a biopsy may show clubbed rete pegs

HEENT

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

Abdomen

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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. ↑ 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.

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