Vickie Case Summary

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Vickie is a 60-year-old female who suffers from moderate to severe plaque psoriasis (L40.0). Her symptoms include dry, red, intensely itchy, scaly plaques located on her hands, legs, feet, arms, and back, with joint pain throughout her hands, wrists and knees. She also reports that her wrists are so extremely sore that she cannot bend them at times and that the plaques on her feet is severely painful which has caused her to stay home from work because she couldn’t walk. Vickie has tried and failed various treatments including triamcinolone, clotrimazole betamethasone, and diprolene. Your denial states that Vickie must use systemic therapy, however, systemic medications such as Methotrexate, she is not a candidate for treatment with Methotrexate

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