Psoriasis is a chronic inflammatory disease of the skin with a likely immunologic basis. Hyperproliferation of epidermal cells leads to thickened, often scaly skin. Lesions usually develop slowly but may have a sudden onset of growth. Psoriasis is commonly categorized as mild (covers less than 3% of the body), moderate (3%-10%), or severe (over 10%).
Genital psoriasis is rather common and usually is comparable with psoriasis found elsewhere on the body. It can be isolated to the genitalia but is frequently part of more generalized involvement. Involvement of the inguinal or crural areas is termed inverse psoriasis. Some individuals have tenderness during sexual intercourse.
Psoriasis - Anogenital in
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Synopsis
Codes
ICD10CM:
L40.0 – Psoriasis vulgaris
SNOMEDCT:
9014002 – Psoriasis
L40.0 – Psoriasis vulgaris
SNOMEDCT:
9014002 – Psoriasis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Lichen sclerosus
- Lichen simplex chronicus
- Chronic atopic dermatitis patients are often aware of their atopic history, which commonly starts in childhood. Mild-to-moderate spongiosis seen on histology. Look for lichenified plaques on the flexural surfaces and neck. More pruritic than psoriasis.
- Contact dermatitis
- Seborrheic dermatitis – Sebaceous distribution.
- Lichen planus – Very pruritic, associated with hepatitis C. Biopsy will differentiate psoriasis from lichen planus.
- Tinea corporis – Scale at leading edge of erythema with central clearing. Check potassium hydroxide (KOH) preparation.
- Irritant contact dermatitis
- Extramammary Paget disease
- Fixed drug eruption
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:05/02/2023
Last Updated:08/08/2022
Last Updated:08/08/2022
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Psoriasis - Anogenital in
See also in: Overview,Hair and Scalp,Nail and Distal Digit