Psoriasis - Risk Factors

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Skin Injuries and the Koebner Response. The Koebner response is a delayed response to skin injuries, in which psoriasis develops later at the site of the injury. In some cases, even mild abrasions can cause an eruption, which may be why psoriasis tends to frequently occur on the elbows or knees. However, psoriasis can develop in areas that have not been injured.

Medications. Drugs that can trigger the disease, worsen symptoms, or cause a flare-up include:

• Angiotensin-converting enzyme (ACE) inhibitors, drugs used to treat high blood pressure and heart problems
• Beta-blockers, drugs used to treat high blood pressure and heart problems
• Chloroquine, a medicine used to treat malaria
• Lithium for bipolar disorder treatment
• Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID) -- Note: Other NSAIDs, such as meclofenamate, may actually improve the condition.
• Progesterone, used in female hormone therapies

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Severe flare-ups may occur in people with psoriasis who stop taking their steroid pills, or who discontinue the use of very strong steroid ointments that cover wide skin areas. The flare-ups may be of various psoriatic forms, including guttate, pustular, and erythrodermic psoriasis. Because these drugs are also used to treat psoriasis, this rebound effect is of particular concern.

Medications that cause rashes (a side effect of many drugs) can trigger psoriasis as part of the Koebner response.

Review Date: 10/21/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).