Adult-Onset Psoriasis

A 58-year-old man complained of the recent onset of a widespread, mildly pruritic rash. He was in good health except for about a 1-year history of symptomatic supraventricular arrhythmia.

Key point: Physical examination revealed a disseminated rash consisting of indurated, erythematous plaques variably covered by silver scales. A biopsy was read as psoriasis.

Treatment: The patient responded well to topical application of a mid-potency corticosteroid combined with narrow-band UVB phototherapy.

Note: Adult-onset psoriasis is uncommon without a precipitating factor. This patient was given an oral beta-blocker as management for his arrhythmia. Medications may precipitate otherwise typical psoriasis among those who are predisposed to this disorder.