skip to main content

Facial Psoriasis — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInflammatory DermatosesFacial PsoriasisSCE Dermatology

A 35-year-old woman has psoriasis on her face. She has erythematous scaly patches on her eyebrows and nasolabial folds. The differential includes seborrhoeic dermatitis. What clinical feature helps distinguish facial psoriasis from seborrhoeic dermatitis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Psoriasis typically has more well-defined borders; seborrhoeic dermatitis has ill-defined greasy scale

Facial psoriasis and seborrhoeic dermatitis can be difficult to distinguish (and may coexist — 'sebopsoriasis'). Features favouring psoriasis: well-defined borders, drier/silvery scale (though less prominent on the face than body), involvement of other typical psoriasis sites (scalp, ears, elbows, nails), family history of psoriasis. Features favouring seborrhoeic dermatitis: ill-defined borders, greasy/yellowish scale, involvement limited to sebum-rich areas, history of dandruff. Biopsy may not reliably distinguish them. Treatment overlap exists (topical corticosteroids effective for both), but antifungals (Ketoconazole) help SD specifically while Vitamin D analogues help psoriasis specifically.

Reference: BAD 2020 Psoriasis Guidelines; NICE CKS