Clinical assessment for psoriasis in a primary care setting

Psoriasis is a chronic, inflammatory skin disease that may affect up to 2% of the adult UK population. There is evidence that psoriasis is linked with a number of other conditions including psoriatic arthritis,¹ and a metabolic syndrome which increases risk of hypertension, obesity, type II diabetes and cardiovascular disease.²

As well as considering psoriasis as a multi-system condition it is relevant to consider disease severity, body surface area affected and involvement of cutaneous special sites. For example, hands, feet, nail, scalp and genital involvement may affect a patient’s morbidity with their condition. Disease impact on special sites may be under-recognised and therefore further management not given consideration. A comprehensive clinical assessment should include psychosocial factors including quality of life. The Scottish Intercollegiate Guidelines Network³ states that patients should be assessed in terms of severity of disease, screening for depression, assessment of vascular and articular risk.