• Syphilis
• Chlamydia
• Gonorrhea
• Trichomoniasis

• Herpes simplex
• Varizella zoster virus (Herpes Zoster)

• Non-anogenital verrucae (Common warts)
• Ano-genital verrucae (Condyloma acuminata)

❓poorly understood → Combination of genetic and environmental factors ⇒ trigger factors*

→ Believed to be 🛡️autoimmune ⇒ Strong association with HLA-C

⇒ 🕰️ 🔥 CHRONIC INFLAMMATION

1. 🥿 PLAQUE

1. 🦵🏽  areas exposed to trauma/friction: ellbow, knee, legs, lumbosacral , palms+soles, ⇒ usually ØFACE

1. 〰️ Well-demarcated
2. 🍣  Pink/salmon-colored
3. ❄️ Silver-white SCALES

2. 💅🏽 NAIL 📷→ PITTING or Onycholysis
3. 🦴 psoriatric ARTHRITIS 📷 = 🗼 SpA (=sero-negative arthropathy)

→ More common in patients with nail findings

4. Psoriatric signs:
• 7) 🕯️ CANDLE WAX 📷 ⇒ WHITE LINE remains after SCRAPING ⇒ non-specific
• 8) 🕺🏽 INCOMPLETE OPERCULUM 📷 ⇒ PERIPHERY = ØSCALES + ERYTHEMATOUS, only CENTRAL = SCALES;
• 9) 🩸 AUSPITZ SIGN 📷 ⇒ BLEEDING after SCALE is SCRAPED-OFF
• 10) 💥 KOEBNER SIGN 📷 ⇒ plaques at sites of trauma

severe variants are marked in red:

1. 🥇 Plaque psoriasis (80-90%) = Psoriasis vulgaris
2. Nail psoriasis
3. psoriatric arthropathy
4. 💧 Guttate psoriasis 📷
5. 🪙 Numular psoriasis 📷
6. 💆🏽‍♂️ Scalp psoriasis 📷 📷⇒ ØHair-loss
7. 💪🏽 Flexural (Inverse) psoriasis 📷⇒ ØSCALES
8. ✋🏽 Palmo-Plantar psoriasis 📷 📷
9. ✋🏽🟡 Pustular Palmo-Plantar psoriasis 📷 📷
10. 🟡 Generalized pustular psoriasis 📷 📷⇒ trigger: 💊
11. 🗯️ Erythrodermic psoriasis 📷 📷⇒ >90% skin surface; w/ desquamation ⇒ trigger: stop 💊
12. Other: Genital muscosa 📷 + face psoriasis 📷

1. Hyperkeratosis (↑s.corneum)
2. Parakeratosis = RETAINED NUCLEI in s.corneum
3. Acanthosis = ↑epidermis
• ↑ S. spinosum
• ↓/Ø S. granulosum
4. Dermis blood vessel → surface ⇒ scale breaks → BLEEDING = AUSPITZ SIGN
5. Np from Dermis → S.corneum ⇒ MUNRO MICRO-ABSCESSESS

1. 👉🏽 TOPICAL
• 🥟 Keratolytics → Salicylic acid
• 🌝 steroids
• 🍦 Calcipotriol (VitD analogue)
2. 🔆 Phototherapy
• Narrowband UVB therapy
• PUVA therapy
3. ♻️ SYSTEMIC ⇒ IF >30% or COMPLICATED FORM
• Retinoids (Acitretin)
• Immunosuppressives
• MTX
• Cyclosporin
• Biologicals

1. ❄️OTHER PAPULO-SQUAMOUS LESION
1. Ptyriasis Rosea (+ Syphillis)
2. Lichen Planus (esp. w/ Guttate form)
3. Seborrheic dermatitis (hard esp. with face psoriasis→ look for distant sites)
2. ☄️ DERMATITIS ⇒ esp. NUMMULAR eczema (Øscales, crumbled borders, pruritus, lichenification, other location)
3. 🎾 Lymphoma (B or T cell) ⇒ BIOPSY + SCREENING-TEST