Ch 8

Psoriazis

Vol 1 · sayfa 139 · §3

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Fig. 8.2 Annular plaques of psoriasis due to central clearing. Courtesy Julie V. Schaffer, MD.

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Fig. 8.3 Psoriatic plaques. A, B Note the sharp demarcation and silvery scale. The plaques can vary in thickness and amount of scale. B, Courtesy Lorenzo Cerroni, MD.

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Fig. 8.3 Psoriatic plaques. A, B Note the sharp demarcation and silvery scale. The plaques can vary in thickness and amount of scale. B, Courtesy Lorenzo Cerroni, MD.

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Fig. 8.4 Multiple large plaques of psoriasis. There is obvious symmetry of the plaques on the upper extrem- ities. Some patients have associated pruritus and hemor- rhagic crusts due to scratching. Courtesy Luis Requena, MD.

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Fig. 8.5 Palmar psoriasis. Well demarcated scaly plaques of the volar wrist and palms. Comparison of the color of the plaques in a lightly pigmented (A) versus darkly pigmented (B) patient. Courtesy Kalman Watsky, MD.

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Fig. 8.5 Palmar psoriasis. Well demarcated scaly plaques of the volar wrist and palms. Comparison of the color of the plaques in a lightly pigmented (A) versus darkly pigmented (B) patient. Courtesy Kalman Watsky, MD.

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Fig. 8.6 Palmoplantar psoriasis. Diffuse involvement with erythema and scaling of the palmar (A) and plantar surfaces (B).

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Fig. 8.6 Palmoplantar psoriasis. Diffuse involvement with erythema and scaling of the palmar (A) and plantar surfaces (B).

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Fig. 8.7 Psoriasis of the genitalia. A Well-demarcated erythematous plaques with scale on the glans and shaft of the penis in an adult. B Infantile psoriasis with a well- demarcated erythematous plaque of the diaper area, along with involvement of the penis and scrotum. This is in contrast to atopic dermatitis where there is often sparing of the diaper area. A, Courtesy Lorenzo Cerroni, MD; B, Courtesy Julie V. Schaffer, MD.

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Fig. 8.7 Psoriasis of the genitalia. A Well-demarcated erythematous plaques with scale on the glans and shaft of the penis in an adult. B Infantile psoriasis with a well- demarcated erythematous plaque of the diaper area, along with involvement of the penis and scrotum. This is in contrast to atopic dermatitis where there is often sparing of the diaper area. A, Courtesy Lorenzo Cerroni, MD; B, Courtesy Julie V. Schaffer, MD.

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Fig. 8.8 Guttate psoriasis. A Numerous, small, discrete papules with scale on the thighs. B This adolescent has evidence of a linear Koebner phenomenon in addition to more widely scattered guttate lesions. C Numerous papules due to a sunburn-related Koebner phenomenon. A, Courtesy Kalman Watsky, MD; C, Courtesy Ronald P. Rapini, MD.

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Fig. 8.8 Guttate psoriasis. A Numerous, small, discrete papules with scale on the thighs. B This adolescent has evidence of a linear Koebner phenomenon in addition to more widely scattered guttate lesions. C Numerous papules due to a sunburn-related Koebner phenomenon. A, Courtesy Kalman Watsky, MD; C, Courtesy Ronald P. Rapini, MD.

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Fig. 8.8 Guttate psoriasis. A Numerous, small, discrete papules with scale on the thighs. B This adolescent has evidence of a linear Koebner phenomenon in addition to more widely scattered guttate lesions. C Numerous papules due to a sunburn-related Koebner phenomenon. A, Courtesy Kalman Watsky, MD; C, Courtesy Ronald P. Rapini, MD.

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Fig. 8.9 CARD14-associated erythroderma. Extensive erythema and scale resembling erythrodermic psoriasis. Courtesy Edward Cowen, MD.

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Fig. 8.10 Generalized pustular psoriasis. Broad areas of erythema with numerous pustules and the formation of lakes of pus. Courtesy Julie V. Schaffer, MD.

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Fig. 8.11 Annular pustular psoriasis. A, B Multiple annular inflammatory plaques whose active borders are studded with pustules followed by desqua- mation. As these lesions enlarge, there is central clearing. The intensity of erythema can vary and the color is influenced by the skin phototype. A, Courtesy Marieke M. B. Seyger, MD, PhD; B, Courtesy Julie V. Schaffer, MD.

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Fig. 8.12 Pustulosis of the palms and soles. Multiple sterile papules are admixed with yellow–brown macules on the palm.

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Fig. 8.13 Acrodermatitis continua of Hallopeau. Erythema and slight scale of the distal digit, pustules within the nail bed, and partial shedding of the nail plate.

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Fig. 8.14 Scalp psoriasis with extension onto the neck. Note the involvement of the external auditory canal.

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Fig. 8.15 Inverse psoriasis. Shiny erythematous plaques of the inframammary folds that lack scale. Courtesy Luis Requena, MD.

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Fig. 8.16 Nail psoriasis. Nail plate pitting, distal onycholysis, oil drop changes, and subungual and proximal hyperkeratosis are seen. There is also proximal nail-fold inflammation with loss of the cuticle, especially of the forefingers. Courtesy Marcel C. Pasch, MD.

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Fig. 8.18 Psoriatic arthritis. Asymmetric involvement of the distal interpha- langeal (DIP) and proximal interphalangeal (PIP) joints. A “sausage” digit (third digit bilaterally) results from involvement of both the DIP and PIP joints. Note the yellowing, thickening, and crumbling of several fingernails.

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Fig. 8.19 Reactive arthritis (formerly Reiter disease). A, B Plantar lesions of keratoderma blennorrhagicum. The amount of scale can vary and when sterile pustules form, they are often admixed with yellow–brown macules. C Papulosquamous lesions on the glans and shaft of the penis. B, Courtesy Eugene Mirrer, MD.

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Fig. 8.19 Reactive arthritis (formerly Reiter disease). A, B Plantar lesions of keratoderma blennorrhagicum. The amount of scale can vary and when sterile pustules form, they are often admixed with yellow–brown macules. C Papulosquamous lesions on the glans and shaft of the penis. B, Courtesy Eugene Mirrer, MD.

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Fig. 8.19 Reactive arthritis (formerly Reiter disease). A, B Plantar lesions of keratoderma blennorrhagicum. The amount of scale can vary and when sterile pustules form, they are often admixed with yellow–brown macules. C Papulosquamous lesions on the glans and shaft of the penis. B, Courtesy Eugene Mirrer, MD.

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Fig. 8.20 Sneddon– Wilkinson disease. A Annular and polycyclic plaques in the axilla with small pustules, erosions, and scale in the border. B Numerous, fragile, subcorneal pustules arising within a background of erythema. There is dependent pooling of the pustular contents in some of the larger lesions. There is significant overlap with pustular psoriasis. B, Courtesy Department of Dermatology, Medical University of Graz.

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Fig. 8.20 Sneddon– Wilkinson disease. A Annular and polycyclic plaques in the axilla with small pustules, erosions, and scale in the border. B Numerous, fragile, subcorneal pustules arising within a background of erythema. There is dependent pooling of the pustular contents in some of the larger lesions. There is significant overlap with pustular psoriasis. B, Courtesy Department of Dermatology, Medical University of Graz.

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