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November 6, 1996, Vol 276, No. 17 >
ARTICLE | November 6, 1996

A 61-Year-Old Man With Psoriasis

Richard D. Baughman, MD
JAMA. 1996;276(17):1421-1428. doi:10.1001/jama.1996.03540170065034.
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Dr Delbanco:  Mr J is a 61-year-old man who has had psoriasis covering an increasing proportion of his body since his first psoriatic plaque appeared at the age of 5 years. Married and the father of 5 children, 1 of whom has psoriasis, he works as a senior executive in a manufacturing company in a suburb of Boston, Mass. He is insured by his employer and is enrolled in a managed care plan.His mother, who also has psoriasis, first noted characteristic lesions on his elbows, and he began to visit dermatologists on a regular basis. He recalls treating his skin initially with many different ointments. When he was about 10 years old, lesions appeared also on his knees, and he was treated with vitamin B12 injections. From then on into his 30s, he recalls being treated with whatever was "new and exciting." He received corticosteroids topically. These helped initially,

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