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.