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Note. You should have already read the overview page about psoriasis.
Chronic plaque psoriasis
Chronic plaque psoriasis is the most common form of psoriasis and is characterised by:
Flexural psoriasis (inverse psoriasis)
Flexural psoriasis is characterised by:
Scalp psoriasis may precede psoriasis in other sites by months or years. Typically, scalp psoriasis causes well demarcated erythematosus plaques with silvery white scaling.
The term ‘sebopsoriasis’ is used when the eruption ressembles seborrhoeic dermatitis (diffuse yellowish scale and little inflammation in scalp, diffuse scaling rash behind and inside ears, nasolabial folds, medial cheeks, eyebrows, anterior chest) but has a poor response to anti-dandruff shampoos.
Other forms of plaque psoriasis
Uncommon subtypes of chronic plaque psoriasis include:
It is most important to explain the nature of psoriasis to the patient presenting with psoriasis for the first time. Provide them with written material and refer them to DermNet (http://www.dermnetnz.info/) for further information. They need to be aware that there is no known cure and that psoriasis may persist lifelong. Treatment rarely results in complete clearance but reduces the severity and extent of the disease.
Mild chronic plaque psoriasis is usually managed with topical agents.
If plaque psoriasis is too extensive or severe to be effectively managed with topical treatments alone, refer to a dermatologist for phototherapy and/or systemic agents.
Options for scalp psoriasis include:
Investigate the role of dietary management of psoriasis (including ethanol, gluten-free and low-energy diets, polyunsaturated fatty acids).
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