What is the diagnosis for a patient presenting with diffuse psoriatic (psoriasis) plaques without arthritis?

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Differential Diagnosis for Diffuse Psoriatic Plaques without Arthritis

  • Single most likely diagnosis
    • Psoriasis: This is the most likely diagnosis given the presence of diffuse psoriatic plaques, which are characteristic of the condition. Psoriasis is a chronic autoimmune skin disorder that can present with various types of lesions, including plaques.
  • Other Likely diagnoses
    • Seborrheic dermatitis: This condition can present with diffuse erythematous plaques, particularly on the scalp, face, and torso, which might be confused with psoriatic plaques.
    • Pityriasis rubra pilaris: A rare skin disorder characterized by reddish-orange plaques and palmoplantar keratoderma, which could be considered in the differential diagnosis of diffuse psoriatic plaques.
    • Nummular dermatitis: Also known as discoid eczema, this condition presents with coin-shaped patches of eczema that can resemble psoriatic plaques.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Cutaneous T-cell lymphoma (Mycosis fungoides): Although rare, this condition can mimic various dermatoses, including psoriasis, and is critical to diagnose early due to its potential for severe outcomes.
    • Syphilis (secondary): This infectious disease can cause a wide range of skin manifestations, including diffuse plaques, and is crucial to identify due to its systemic implications and the importance of early treatment.
  • Rare diagnoses
    • Parapsoriasis: A group of rare skin disorders that can present with diffuse, scaly plaques, which might be considered in the differential diagnosis of psoriasis, especially if the presentation is atypical.
    • Lichen planus: While typically presenting with purplish, itchy, flat bumps, lichen planus can occasionally manifest with more diffuse lesions that might resemble psoriatic plaques.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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