Psoriasis
Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: L40.9 DESCRIPTION An inflammatory condition of the skin and joints. DIAGNOSTIC CRITERIA Scaly, red, itchy papules and plaques over scalp, perineum, and skin folds and extensor surfaces. Nails may be opaque, deformed and crumbling. Occasional pustules are seen. GENERAL AND SUPPORTIV
General and supportive measures
ICD-10 code: L40.9
DESCRIPTION
An inflammatory condition of the skin and joints.
DIAGNOSTIC CRITERIA
- Scaly, red, itchy papules and plaques over scalp, perineum, and skin folds and extensor surfaces.
- Nails may be opaque, deformed and crumbling.
- Occasional pustules are seen.
GENERAL AND SUPPORTIVE MEASURES
- Avoid precipitants, e.g. medication (such as antiepileptic and antimalarial agents).
MEDICINE TREATMENT
Local plaques
To remove scales in children 12 years and older
- Salicylic acid 2% and coal tar in white soft paraffin, applied 8 hourly.
OR
- Face: Hydrocortisone 1%, topical, applied 12 hourly.
- Body: Betamethasone 0.1%, topical, applied 12 hourly.
For scalp lesions
To remove scales on scalp:
- Salicylic acid 2% in white soft paraffin, if required, in children 12 years and older.
AND
- Wash with mild coal tar shampoo.
AND
- Betamethasone 1% scalp application, apply 12 hourly
Severe pustular psoriasis (in consultation with a specialist)
- Prednisone, oral, 1–2 mg/kg as a single daily dose for 7 days
REFERRAL
- Severe psoriasis and recalcitrant cases.
- Intolerance to salicylic acid.
- No response to treatment.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 5: Dermatology, 5.3 Macules And Papules, 5.3.6 Psoriasis