Extensive unstable psoriasis--morbidity and medical management

Over a 5 year period, from January 1988 to January 1993, 23 patients were admitted with extensive unstable psoriasis, 21 of whom had full case notes available. Over the study period these 21 patients required 45 admissions, the mean duration of each admission being 30.54 days. Those patients living more than 30 miles from our unit required almost twice as many admissions as the city group. In 77% of cases, a precipitating factor for the acute flare was identified, and in 53% of these the precipitating factor was iatrogenic related. These patients are prone to develop complications of which infection is the most common. The complexity of medical management was reflected in the number of cross consultations requested. These findings have implications for the optimal delivery of care to this important sub-group of psoriatics.