[Severe psoriasis: 160 cases].
BACKGROUND
Psoriasis is a frequent dermatosis, its prevalence is estimated of between 1 and 3 p. 100. The severe forms may threaten the functional and life prognosis of patients.


METHODS
We conducted a retrospective study on 160 cases of severe psoriasis collected between 1990 and 2001. We included patients exhibiting severe psoriasis: pustular, erythrodermic or arthropathic psoriasis, the generalized forms that had developed for more than 6 months, without positive response to treatment and the forms with a PASI greater than 50.


RESULTS
The patients' ages ranged from 6 to 85 years with a clear male predominance (96 men, 64 women). Nine familial cases were collected. Erythroderma was noted in 87 cases, pustular psoriasis in 31, generalized psoriasis in 31 and psoriatic rheumatism in 15 (4 of which were associated with pustular psoriasis). Local treatment with topical corticosteroids or a Vitamin D derivative was recommended in respectively 41.8 and 13.75 p. 100 of cases. The administration of general treated relied on methotrexate and was required in 68.75 p. 100 of cases. Progression was usually good, relapses were often noted when treatment was stopped. Four patients died.


CONCLUSIONS
Although the diagnosis of psoriasis is often easy, the severe forms are still difficult to treat. Treatment is complicated, sometimes disappointing and often necessitates heavy and aggressive treatments that require strict surveillance.
Jalal
O
O
Service de Dermatologie et de Vénéréologie, CHU Mohammed VI, Marrakech, Maroc. oujalal55@hotmail.com
Houass
S
S
Laissaoui
K
K
Hocar
O
O
Charioui
S
S
Amal
S
S
D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014807:Vitamin D / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; D014807:Vitamin D; D008727:Methotrexate