Clinical QuickieDermatology
Psoriasis
Treat the skin — and screen the joints.
Recognize the pattern
Well-demarcated scaly plaques on extensor surfaces, scalp, sacrum, or nails support psoriasis; inverse and special-site disease may look different.
Topicals depend on body site
Corticosteroid potency and duration must match the location and severity. Face/folds need a different approach than thick plaques on elbows or knees.
Systemic disease matters
Joint pain, morning stiffness, dactylitis, heel pain, and functional decline can signal psoriatic arthritis.
Escalate when disease burden is bigger than the BSA
Special-site disease, significant quality-of-life impact, refractory plaques, extensive disease, or inflammatory arthritis may need phototherapy/systemic/biologic treatment.
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