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      Relation between the Peripherofacial Psoriasis and Scalp Psoriasis

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          Facial involvement of psoriasis is known to be one of the clinical manifestations that indicate the severity of the psoriasis and thought to be more closely associated with certain distribution. Centrofacial (CF) psoriasis has been suggested to be related with severity of systemic disease while peripherofacial (PF) psoriasis has been thought to have connection with scalp psoriasis.


          To analyze the epidemiologic characteristics, clinical features and subjective feelings of patients with facial psoriasis and to find out relationship between scalp psoriasis and facial involvement according to the facial types.


          One hundred nineteen facial psoriasis patients were categorized into 3 types according to the distribution: PF type, CF type and mixed facial (MF) type. Onset and duration of facial and scalp psoriasis, and their relationship were questioned. Severity and extent of psoriasis on whole body, face, and scalp were rated by clinicians.


          There was no significant difference of whole body psoriasis area and severity index (PASI) and body surface area (BSA) score but scalp PASI and BSA was much higher in PF psoriasis compared to CF psoriasis (scalp PASI, 17.9 vs. 10.1; p=0.005) (scalp BSA, 40.9 vs. 22.2; p=0.002). According to the questionnaire, patient's objective feeling about the spreading of scalp lesion to facial area was markedly more prominent in the patients with peripheral involvement (PF+MF, 90.1%; CF, 54.2%; p<0.0001).


          Among subtypes of facial psoriasis, PF psoriasis is closely associated with spreading of scalp lesion into the face rather than reflecting the disease severity.

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          Most cited references 12

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          Psoriasis of early and late onset: a clinical and epidemiologic study from Spain.

          The existence of 2 distinct forms of psoriasis related to age at onset has been postulated. However, precise data regarding the clinical and epidemiologic characteristics of psoriasis depending on the age at onset are still lacking. The purpose of this study was to define the clinical and epidemiologic features of this disease in Spain and to compare patients with psoriasis of early and late onset. An observational, analytic, cross-sectional, multicenter study was carried out. From January 1999 to November 1999, 179 participating dermatologists completed a questionnaire detailing the clinical and epidemiologic features of the first 10 consecutive patients with psoriasis seen in their clinical practice. The sample distribution was proportional to the Spanish population. Both statistical and descriptive analyses were performed. Available data were obtained from 1774 patients. The onset of the disease before 30 years of age was significantly associated with a higher incidence of family history of psoriasis, a more severe and extensive cutaneous involvement, and greater psychosocial impact. Guttate psoriasis, nail involvement, evidence of precipitating factors, and a recurrent clinical course were more frequent in this group of patients. Patients with psoriasis of late onset had a less severe clinical course and a more continuous evolution. Palmoplantar pustulosis was more frequent in this group of patients. No significant relationship was detected between the age at onset and development of joint involvement. Patients with early and late onset psoriasis often show different clinical and evolutionary features. From the analysis of our data, it seems that 2 different groups of patients with psoriasis related to age at onset can be defined.
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            Classification of facial psoriasis based on the distributions of facial lesions.

            Psoriasis is a common chronic inflammatory skin disease that may involve any skin site. In particular, psoriasis on the face gives rise to considerable concern because of associated cosmetic problems and psychosocial distress. Some authors have reported that a significant proportion of patients with psoriasis have facial involvement, and several reports have suggested that facial involvement is a marker of severe psoriasis. However, patients with facial psoriasis seem to have clinical characteristics that depend on the distributions of their facial lesions.
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              Facial psoriasis: comparison of patients with and without facial involvement


                Author and article information

                Department of Dermatology, National Medical Center, Seoul, Korea.
                Author notes
                Corresponding author: Jai Il Youn, Department of Dermatology, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. Tel: 82-2-2260-7315, Fax: 82-2-2277-0915, nmcderma@
                Ann Dermatol
                Ann Dermatol
                Annals of Dermatology
                Korean Dermatological Association; The Korean Society for Investigative Dermatology
                August 2016
                26 July 2016
                : 28
                : 4
                : 422-426
                Copyright © 2016 The Korean Dermatological Association and The Korean Society for Investigative Dermatology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article


                scalp, psoriasis, face


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