13f. Skin Health - Psoriasis Flashcards
What is psoriasis?
AI skin condition
Characterised by hyperkeratosis
How does psoriasis present?
Symmetric
Well-defined
Salmon coloured plaques
Overlapping thick silvery scales
Where does psoriasis usually present?
Scalp
Elbows
Knees
Ankles
How are nails affected by psoriasis?
Pitting
Flaking
Oil drop stippling
What time of year is psoriasis usually worse?
Winter
What is the pathogenesis of psoriasis?
AI
Dysregulated T-cell mediated inflammation
Keratinocyte proliferation
Dysfunctional differentiation
What are the two phases of the development of psoriasis?
Initiation phase
Maintenance phase
What does the initiation phase of psoriasis development consist of?
Keratinocytes respond to a trigger
Dendritic cells stimulated
Cytokine production
T-helper cell differentiation
What does the maintenance phase of psoriasis development consist of?
T-helper cells release cytokines
Keratinocyte proliferation
More inflammatory cells
What are the complications of psoriasis?
Psoriatic arthritis
CVD
IBD
Causes and risk factors for psoriasis
Genetics
Trauma
Vaccination
Air pollution
Medications
Infectious agents
Smoking
Alcohol
Metabolic syndrome
Gut dysbiosis
High toxic load
Poor protein digestion
Chronic stress
NAFLD
Which genes makes an individual more susceptible to psoriasis?
HLA-Cw6
PSORS1
Why is trauma a risk factor for psoriasis?
Often appears in areas after injury
Which vaccinations is psoriasis development associated with?
Flu
COVID-19
Which medications are considered risk factors for psoriasis?
Corticosteroids
NSAIDs
Beta-blockers
Anti-malarial
Which bacteria is associated with psoriasis?
Streptococcus pyogenes
Why is smoking a risk factor for psoriasis?
Increases oxidative stress
Increases NF-kB and inflammatory cytokines
Why is alcohol a risk factor for psoriasis?
Ethanol increases TNF-a
Increases lymphocyte proliferation
Increase mast cell histamine release
Why is metabolic syndrome a risk factor for psoriasis?
Inflammation increases adipose tissue
This leads to abnormal fatty acid metabolism
High serum FFAs sensitises dendritic cells to amplify Th1/Th17 responses
Why is gut dysbiosis a risk factor for psoriasis?
Linked to reduced Akkermansia and Bacteroides
Increased Firmicutes phylum
Why is poor protein digestion a risk factor for psoriasis?
Produces polyamines which can induce excess cell proliferation through the inhibition of cAMP
(cyclic adenosine monophosphate)
Why is NAFLD a risk factor for psoriasis?
Twice as prevalent in psoriasis
Insulin resistance likely to be a contributing factor
Why is chronic stress a risk factor for psoriasis?
Reduced cortisol/increased adrenaline, noradrenaline stimulate mast cells
Affects skin barrier function
Upregulates proinflammatory cytokines
Naturopathic approach to psoriasis
Naturopathic diet with focus on fibre
AO-rich fruit/veg
EFAs
Detox protocol
AI protocol
Digestive support
Pre-/probiotics
Weight loss
Stress management
Reduce toxic load
