Psoriasis in special localizations

Abstract

Psoriasis is a chronic inflammatory dermatosis affecting 1–3% of the general population. Patients with psoriasis represent a heterogeneous population with individual disease expression – different degrees and severity of skin involvement. Psoriatic lesions in particular localizations such as the face, scalp, intertriginous or palmoplantar areas significantly reduce quality of life. Patients often feel ashamed, embarrassed, or self-conscious about their symptoms. Furthermore, genital psoriasis significantly affects sexual health. Among patients with psoriasis, the prevalence of special localizations is estimated to be 23–27% on the nails, 49% on the face, 12–16% on the palms and soles, and up to 36% in intertriginous regions. Due to peculiar features of skin in these areas, adequate and specific management is required, which is discussed in this review.

Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations

“…Such goals may, however, need to be reconsidered in patients with psoriasis affecting sensitive body areas, such as face, scalp, palms, soles, nails and genitalia (statement 1.6). Evidence shows that the involvement of these areas has a negative psychological impact [ 41 ], which translates into worse disease severity compared with disease severity assessed by objective measures (such as BSA or PASI) only [ 42 , 43 ]. The treatment goal (PASI90 response or absolute PASI score less than or equal to 3) should be maintained over time, which implies a tight control of disease course (statement 1.8).…”

Machine Learning in Dermatology: Current Applications, Opportunities, and Limitations

“…However, this model was limited to classifying psoriasis located on large areas of exposed skin due to the low quality and lack of scalp and nail psoriasis images. This is a notable limitation considering that the incidence of scalp psoriasis is 45-56% and nail psoriasis is 23-27% among psoriatic patients [57]. CNNs have been created for other diseases, such as atopic dermatitis [58], onychomycosis [56], and rosacea [59].…”

Precision therapy for psoriasis patients

“…Локализация высыпаний имеет значение в прогнозировании течения заболевания. Элементы сыпи на волосистой части головы, складках кожи, ладонноподошвенной областях относятся к «проблемной локализации» и ассоциированы с резистентным к лечению вариантом болезни [48]. Высыпания на лице -прогностические факторы тяжелого течения псориаза [48,49].…”