Psoriasis

61y, white woman, h/o HTN, CAD, severe vasculopathy- s/p coronary stents and renal arterty stents, bilateral moderate carotid stenosis and psoriasis comes in for a routine follow up. She is asymptomatic on her current drug regimen- Diovan-HCT 160/12.5mg qd, Metoprolol XL 100mg qhs, ISMO 60mg qd, Lovastatin 40mg qhs, Calcipotriene topical bid, Lasix 20mg qd, ASA and NTG s.l. prn. Her vital signs are stable. Exam reveals psoriatic plaques on both the elbows, with mildly erythematous base and rim with superficial silvery scales. She has similar smaller plaques on her legs. Which of the following statements is false?

1. She has a 30% likelihood of having psoriatic arthritis
2. Arthritis precedes skin lesions in 15% of patients with psoriasis
3. She is on a medicine that could exacerbate her skin lesions
4. Calcipotriene, although very effective, is extremely expensive as compared to topical steroids.
5. She has guttate variant of psoriasis, commonly linked to Streptococcal infections - CORRECT ANSWER