Differentiating psoriasis from other diseases: Difference between revisions

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**Tinea manuum/pedum/capitis  
**Tinea manuum/pedum/capitis  
**Seborrheic dermatitis
**Seborrheic dermatitis
{| class="wikitable"
!Disease
!Rash Characteristics
!Signs and Symptoms
!Associated Conditions
|-
|Cutaneous T cell lymphoma/Mycosis fungoides<ref name="urlMycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq |title=Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
|
** Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
** Patch phase: Thin, reddened, eczema -like rash.
** Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be reddened.
** Tumor phase: Tumors form on the skin. These tumors may develop ulcers and the skin may get infected.
|
* Generalized itching (pruritus)
* Pain in the affected area of the skin.
* Insomnia
* Red (erythematous) patches scattered over the skin of the trunk and the extremities
* Tumor-like lobulated outgrowths form on the skin in the latter part of the disease
* Weight loss
* Lymphadenopathy
* Malaise and fatigue
* Anemia
* May progress to Sezary syndrome (Skin involvement plus hematogenous dissemination)
|
* Sezary syndrome
|-
|Pityriasis rosea<ref name="pmid27512182">{{cite journal |vauthors=Mahajan K, Relhan V, Relhan AK, Garg VK |title=Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects |journal=Indian J Dermatol |volume=61 |issue=4 |pages=375–84 |year=2016 |pmid=27512182 |pmc=4966395 |doi=10.4103/0019-5154.185699 |url=}}</ref>
|
* Pink or salmon in colour, which may be scaly, termed as "herald patch"
* Oval in shape
* Long axis oriented along the clevage lines
* Distributed on the trunk and proximal extremities
* Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
* Develops after viral infection
* Resolves spontaneously after 6-8 weeks
|
* Preceded by a prodrome of:
** Sore throat
** Gastrointestinal disturbance
** Fever
** Arthralgia
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* Infection by any of the following:<ref name="pmid19997691">{{cite journal |vauthors=Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A |title=Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea |journal=Acta Derm. Venereol. |volume=89 |issue=6 |pages=604–6 |year=2009 |pmid=19997691 |doi=10.2340/00015555-0703 |url=}}</ref>
** HHV-6
** HHV-7
** HHV-8
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|Pityriasis lichenoides chronica
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* Recurrent lesions are usually less evenly scattered than psoriasis
* Brownish red or orange-brown color
* Lesions are capped by a single detachable opaque mica-like scale
* Often leave hypopigmented macules
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 16:28, 19 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differentiating Psoriasis from other Diseases

  • Psoriasis must be differentiated from other diseases causing papulosquamous or erythematosquamous rash especially when the psoriatic lesions are localized in particular sites for example, palms, soles, scalp, body folds, penis and nails.
  • The differentials include:
    • Cutaneous T cell lymphoma/mycosis fungoides
    • Pityriasis rosea
    • Pityriasis rubra pilaris
    • Pityriasis lichenoides chronica
    • Nummular dermatitis
    • Secondary syphilis
    • Bowen’s disease
    • Exanthematous pustulosis
    • Hypertrophic lichen planus
    • Sneddon–Wilkinson disease
    • Small plaque parapsoriasis
    • Intertrigo
    • Langerhans cell histiocytosis
    • Dyshidrotic dermatitis
    • Tinea manuum/pedum/capitis
    • Seborrheic dermatitis
Disease Rash Characteristics Signs and Symptoms Associated Conditions
Cutaneous T cell lymphoma/Mycosis fungoides[1]
    • Premycotic phase: A scaly, red rash in areas of the body that usually are not exposed to the sun. This rash does not cause symptoms and may last for months or years.
    • Patch phase: Thin, reddened, eczema -like rash.
    • Plaque phase: Small raised bumps (papules) or hardened lesions on the skin, which may be reddened.
    • Tumor phase: Tumors form on the skin. These tumors may develop ulcers and the skin may get infected.
  • Generalized itching (pruritus)
  • Pain in the affected area of the skin.
  • Insomnia
  • Red (erythematous) patches scattered over the skin of the trunk and the extremities
  • Tumor-like lobulated outgrowths form on the skin in the latter part of the disease
  • Weight loss
  • Lymphadenopathy
  • Malaise and fatigue
  • Anemia
  • May progress to Sezary syndrome (Skin involvement plus hematogenous dissemination)
  • Sezary syndrome
Pityriasis rosea[2]
  • Pink or salmon in colour, which may be scaly, termed as "herald patch"
  • Oval in shape
  • Long axis oriented along the clevage lines
  • Distributed on the trunk and proximal extremities
  • Squamous marginal collarette and a “fir-tree” or “Christmas tree” distribution on the posterior trunk
  • Develops after viral infection
  • Resolves spontaneously after 6-8 weeks
  • Preceded by a prodrome of:
    • Sore throat
    • Gastrointestinal disturbance
    • Fever
    • Arthralgia
  • Infection by any of the following:[3]
    • HHV-6
    • HHV-7
    • HHV-8
Pityriasis lichenoides chronica
  • Recurrent lesions are usually less evenly scattered than psoriasis
  • Brownish red or orange-brown color
  • Lesions are capped by a single detachable opaque mica-like scale
  • Often leave hypopigmented macules

References

  1. ↑ "Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)—Patient Version - National Cancer Institute".
  2. ↑ Mahajan K, Relhan V, Relhan AK, Garg VK (2016). "Pityriasis Rosea: An Update on Etiopathogenesis and Management of Difficult Aspects". Indian J Dermatol. 61 (4): 375–84. doi:10.4103/0019-5154.185699. PMC 4966395. PMID 27512182.
  3. ↑ Prantsidis A, Rigopoulos D, Papatheodorou G, Menounos P, Gregoriou S, Alexiou-Mousatou I, Katsambas A (2009). "Detection of human herpesvirus 8 in the skin of patients with pityriasis rosea". Acta Derm. Venereol. 89 (6): 604–6. doi:10.2340/00015555-0703. PMID 19997691.

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