Dermal Distress

🗒️ Question 

A 32 year old man presents to his GP with well-demarcated, erythematous plaques covered with silvery scales on his elbows and knees. He also complains of occasional joint pain, particularly in his fingers. The plaques have been present for the past 6 months and have progressively worsened despite over the counter emollients. He mentions that his father had a similar condition.

On examination, the plaques are noted to be 2-5 cm in diameter, with a positive Auspitz sign. His BMI is 28 and he reports a recent increase in weight. He has no significant past medical history otherwise and is not currently on any medication.

What is the most appropriate initial treatment?

(A) Topical corticosteroids
(B) Methotrexate
(C) Phototherapy
(D) Topical calcineurin inhibitors
(E) Oral corticosteroids