Content reviewed by Ann Dietrich, MD, FAAP, FACEP

ICD-10 Code Category: L40

Psoriasis is a chronic autoimmune inflammatory condition with different subtypes such as plaque, flexural, guttate, pustular or erythrodermic. It affects millions of people globally and can significantly impact the quality of life.

Nurses play a vital role in managing psoriasis, providing patient education, and offering emotional support.

This article explores the ICD-10 codes associated with psoriasis, detailed descriptions of each code, and practical nursing applications.

Key ICD-10 Codes for Psoriasis

L40.0 – Psoriasis vulgaris
L40.1 – Generalized pustular psoriasis
L40.2 – Acrodermatitis continua
L40.3 – Pustulosis palmaris et plantaris
L40.4 – Guttate psoriasis
L40.5 – Arthropathic psoriasis
L40.8 – Other psoriasis
L40.9 – Psoriasis, unspecified

Detailed descriptions and nursing applications

L40.0 – Psoriasis Vulgaris

Description: Also known as plaque psoriasis, this is the most common form of psoriasis. It is characterized by red lesions covered with white, sometimes silvery, scales. It is often raised and inflamed. These plaques often appear on the elbows, knees, scalp, and lower back.

Nursing application: Nurses should focus on skin care management, including the use of topical treatments such as corticosteroids and moisturizers to reduce scaling and inflammation. Educating patients about avoiding skin trauma and using gentle skin care products can help prevent flare-ups.

L40.1 – Generalized Pustular Psoriasis

Description: This severe form of psoriasis presents with widespread pustules on an erythematous background. It can be life-threatening and often requires hospitalization.

Nursing application: In acute cases, nurses should monitor vital signs and provide supportive care. Administering systemic treatments, such as biologics or methotrexate, may be necessary. Nurses should educate patients on recognizing early symptoms of flare-ups and the importance of prompt medical attention.

L40.2 – Acrodermatitis Continua

Description: A rare form of pustular psoriasis that affects the fingers and toes, leading to the formation of pustules and scaling.

Nursing application: Nurses should focus on pain management and preventing secondary infections. Educating patients on proper nail care and the use of protective gloves can help manage symptoms and prevent exacerbations.

L40.3 – Pustulosis Palmaris et Plantaris

Description: This type of psoriasis affects the palms of the hands and the soles of the feet, causing pustules and plaques that can be painful and debilitating.

Nursing application: Nurses should assist patients in managing pain and maintaining mobility. Emphasizing the importance of appropriate footwear and providing education on using emollients and topical treatments can alleviate symptoms.

L40.4 – Guttate Psoriasis

Description: Characterized by small, drop-shaped lesions, guttate psoriasis often appears after a streptococcal throat infection and primarily affects children and young adults.

Nursing application: Nurses should educate patients and their families about the potential triggers of guttate psoriasis and the importance of treating streptococcal infections promptly. Topical treatments and phototherapy may be recommended.

L40.5 – Arthropathic Psoriasis

Description: Also known as psoriatic arthritis, this condition involves both skin lesions and joint inflammation, leading to pain and stiffness.

Nursing application: Nurses should focus on pain management and mobility enhancement. Coordinating care with rheumatologists and physical therapists is essential. Educating patients on the importance of regular exercise and weight management can help reduce joint stress.

L40.8 – Other Psoriasis

Description: This code includes less common forms of psoriasis that do not fit into the other specific categories.

Nursing application: Nurses should provide individualized care based on the specific type and severity of psoriasis. Collaborating with dermatologists to develop a comprehensive treatment plan is crucial. Providing emotional support and resources for patient education is also important.

L40.9 – Psoriasis, Unspecified

Description: This code is used when the specific type of psoriasis cannot be determined.

Nursing application: Nurses should advocate for thorough diagnostic evaluations to identify the exact type of psoriasis. Keeping detailed patient records and histories can aid in diagnosis and treatment planning. Educating patients on general psoriasis management strategies is essential.

Nursing care and management

Skin care management

Managing psoriasis involves meticulous skin care to prevent flare-ups and complications. Nurses should:

Educate patients on the importance of regular moisturizing to reduce dryness and scaling.
Advise on the use of gentle, fragrance-free skin care products.
Teach patients to avoid skin trauma and triggers that can exacerbate psoriasis.

Pain and symptom management

Psoriasis can be painful and itchy. Effective symptom management includes:

Administering prescribed topical and systemic medications
Educating patients on non-pharmacologic methods such as oatmeal baths and cold compresses
Encouraging adherence to treatment regimens to manage symptoms effectively

Emotional support and counseling

Living with psoriasis can lead to emotional distress and social isolation. Nurses play a key role in providing emotional support by:

Offering counseling services or referrals to mental health professionals
Facilitating support groups where patients can share their experiences
Providing educational materials to help patients understand their condition and treatment options

Patient education

Educating patients about psoriasis is crucial for effective self-management. Key educational points include:

Understanding the chronic nature of psoriasis and the importance of ongoing management
Recognizing and avoiding triggers that can cause flare-ups
Adherence to prescribed treatments and regular follow-up appointments

ICD-10 Psoriasis Code