scalp psoriasis well demarcated plaques


  • Is a common long term inflammatory skin condition with various clinical patterns
  • The most common subtype is plaque psoriasis which is characterised by red, well demarcated plaques with silvery scale
  • Plaque psoriasis tends to be localised on extensor surfaces of upper, lower limbs, elbows, knees, scalp
  • Other clinical forms include: pustular psoriasis, guttate psoriasis, palmoplantar psoriasis, erythrodermic psoriasis
  • Guttate psoriasis is more common in young adults and has usually an acute onset, frequently after a sore throat caused by streptococcal infection
  • Erythrodermic psoriasis is an emergency and patients require even hospital admission to be stabilised
  • Nail involvement is commonly observed in any type of psoriasis and sometimes patients can have only nail psoriasis with no other clinical signs, making it difficult to diagnose in early stages
  • Nail psoriasis can be easily mistaken with fungal infection
  • Multiple risks can predispose to psoriasis: genetic factors, obesity, smoking, alocohol intake, some drugs, bacterial or viral infections, emotional stress
  • Patients with skin psoriasis are at risk to develop joint involvement known as psoriatic arthritis
  • Psoriatic arthritis can have onset before skin involvement, simultaneously or after
  • Psoriasis is a clinical diagnosis, but sometimes might require a skin biopsy if the appearance isn’t typical
  • When psoriasis is limited to scalp and face it can resemble seborrheic dermatitis and actually these two conditions can coexist and the term ‘sebopsoriasis’ is used when a clear distinction cannot be made
Treatment falls under 3 categories:


1. Topicals (applied directly on the skin)

  • Corticosteroids
  • Vitamin D preparations
  • Coal tar preparations
  • Calcineurin inhibitors

2. Phototherapy

  • Uses UV light
  • Should be used for limited time
  • Treatment is given 2 or 3 times a week
  • Requires commitment to multiple appointments weekly
  • Can increase the risk of skin cancer that is why the number of sessions one can have during lifetime are limited

3. Systemic drugs (oral or injectable)

  • Done under strict supervision of a specialist because of possible side effects
  • Require blood test monitoring
  • Reserved for severe cases
plaque psoriasis
palmoplantar psoriasis hand psoriasis
nail psoriasis
guttate psoriasis