Journal of Asia Pacific Aesthetic Sciences

Muh Nazir Lathif, Elisabet Rumiris Sirait, Fadhilah Isaac Kartika, Stefani Dyah Monisa Asmarani Hernowo, Hafiidh Ilham Kharisma

Abstract: Psoriasis is a chronic inflammatory skin disease characterised by changes in epidermal cell growth and differentiation. The lesions are circumscribed squamous erythematous plaques, layered with silvery white scales usually localised on the elbows, knees, scalp or cover most of the body. It is chronic because 17% - 55% of cases relapse over varying periods of time, which is closely related to stress factors as well as genetics. In this case, we will report a case of severe psoriasis vulgaris. A 57-year old, Indonesian woman, married, came to UNS Hospital, Solo, with complaints of itchy red rashes on both hands, body, back and both legs. The skin lesions appeared at the same time when the patient's husband died and worsened if the patient felt sad. A history of similar complaints occurred in 2014 and 2018, and has been experienced by the patient's father. The patient was a private employee, fully conscious and vital signs were within normal limits. On physical examination, the patient was found to have round well-defined erythema plaques combined with thick squama, hypopigmented papules, pustules to erythema plaques scattered on the patient's body, more than 30% BSA (body surface area). Moreover, Beau's line on the left thumbnail was spotted. Additionally, a wax spot phenomenon and positive Auspitz sign were found. A diagnosis of severe Psoriasis Vulgaris was then made. Medical management included oral Methotrexate and Cetirizine, with topical Dexamethasone 0.01% and phototherapy. Information about the disease condition and prevention was also delivered as nonmedical therapy. The existing treatments aim to suppress symptoms, although not a complete cure.