Psoriasis

Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using.

Click here to access the Primary-Healthcare-Chapter-5-Skin-Conditions-with-Supporting-NEMLC-Report-2020-4-Review-Version-2.0-November-2025

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Description

General Measures

Medicine Treatment

Referral

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ICD 10 code: L40.0-5/L40.8-9

DESCRIPTION

• Inflammatory condition of the skin and joints of unknown aetiology. Lesions present as scaly, itchy plaques, especially on the extensor surfaces of the knees, elbows, sacrum and scalp
• Psoriasis may spread to involve other sites, although the face is usually spared
• The nails and skin folds are often involved
• Often aggravated by stress, and may be provoked by HIV disease

GENERAL MEASURES

• Counselling regarding precipitating factors and chronicity
• HIV test, if acute onset and patient has risk factors for HIV infection
• Encourage sun exposure as tolerated

MEDICINE TREATMENT

For flares (if delay experienced in obtaining a dermatological consultation):

• Coal tar (Liquor picis carbonis (LPC)) BP 5%, topical one to four times daily

OR

• Corticosteroid, potent, topical, e.g.: (Doctor prescribed)
  • Betamethasone 0.1%, topical, apply 12 hourly 
    • Decrease according to severity, reduce to hydrocortisone 1%, topical, and then stop

LoE: IVb³³

REFERRAL

• All patients, if diagnosis is not already confirmed
• Complications such as pustular psoriasis, acute flares, chronic local plaques

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_07 November 2024

Chapter 5: Skin Conditions_5.16 Psoriasis