Clinical Presentation of Psoriasis

Psoriasis, a chronic papulosquamous inflammatory skin disease, was originally thought of as a primary disorder of epidermal keratinocytes, but is later on recognized as one of the commonest immune-mediated disorders [1, 2]. Although psoriasis starts with the involvement of skin, but limiting this disease to a skin problem is rather a restrictive approach. Psoriasis has been linked to a number of other diseases especially metabolic derangements and arthritis [3-5]. The disease imparts a huge socio-economic burden [6, 7] and the diagnosis of psoriasis is purely based on clinical features. Depending upon the type of psoriasis, onset may be abrupt or slowly progressive. Although it may appear at any age, but majority of patients experience the first episode before the age of 40 years and is uncommon before 10 years [8]. The population based study at Mayo Clinic, suggest that psoriasis tends to appear at an earlier age in females compared to males [9]. A study by Henseler et al. suggested that many psoriatic patients show bimodal distribution i.e. peak between 16-22 years and later between 57-60 years [2, 10].