Explaining chronic plaque psoriasis and topical therapy — OSCE

Candidate instructions (8-minute station)

You are the paediatric registrar in the clinic. An 11-year-old girl has a one-year history of thick, well-demarcated, scaly patches on the elbows, knees and scalp, with nail pitting. Her father has psoriasis, she is overweight, and she has become reluctant to wear short sleeves at school. The family asks whether the condition is contagious, whether the creams are safe, and whether it will go away. ^[1]

Your tasks are: ^[1]

1. Explain the diagnosis of psoriasis in plain, reassuring language, including that it is not contagious and that it is a chronic immune-mediated condition that often runs in families. ^[2]
2. Explain the topical treatment — a potency-matched corticosteroid plus calcipotriol — and the safety rules, including why a milder cream is used on the face and flexures. ^[1]
3. Explain the comorbidities to watch for — weight, joints and mood — and why controlling the weight matters. ^[11]
4. Set the expectation for the long term, including when stronger treatments such as phototherapy or a biologic might be considered. ^[1]

You are not expected to start a systemic or biologic agent in this station — that decision is made with a dermatologist. ^[9]