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4: Y4 - Dermatology [3] > [2] Generalised Pustular Psoriasis > Flashcards

[2] Generalised Pustular Psoriasis Flashcards

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Dermatology Board Prep flashcards
1
Q

What is generalised pustular psoriasis?

A

An extremely rare type of psoriasis that can present in a variety of forms

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2
Q

What does generalised pustular psoriasis require?

A

Emergency hospital referral

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3
Q

What age groups can generalised pustular psoriasis present in?

A

Any but rarer in younger children

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4
Q

What do most cases of generalised pustular psoriasis occur alongside?

A

Existing prior psoriasis conditions

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5
Q

What are some recognised triggers for generalised pustular psoriasis?

A
  • Systemic steroid withdrawal
  • Drugs
  • Topical medications causing irritation
  • Infections
  • Sunlight or phototherapy
  • Cholestatic jaundice
  • Hypocalcaemia
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6
Q

What drugs can cause generalised pustular psoriasis?

A
  • Salicylates
  • Lithium
  • Penicillin
  • Hydroxychloroquine
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7
Q

What topical medications can cause generalised pustular psoriasis?

A
  • Coal tar
  • Steroids under occlusive dressing
  • Anthralin
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8
Q

How does generalised pustular psoriasis first present?

A

Red and tender skin with clusters of pustules appearing within hours

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9
Q

Describe the lesions in generalised pustular psoriasis?

A

Multiple small (2-3mm) yellowish pustules develop in an erythematous background and may spread to a generalised pattern

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10
Q

What happens to generalised pustular psoriasis lesions over 24 hours?

A

The pustules coalesce, dry and desquamate in sheets

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11
Q

What areas are most commonly affected in generalised pustular psoriasis?

A

Flexural and anogenital regions

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12
Q

Where may pustules also appear in generalised pustular psoriasis?

A

On the tongue and under the nails

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13
Q

What can pustules on the tongue cause in generalised pustular psoriasis?

A

Dysphagia

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14
Q

What can pustules under the nails cause in generalised pustular psoriasis?

A

Loss of nails

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15
Q

What are the systemic symptoms of generalised pustular psoriasis?

A
  • Headache
  • Fever
  • Chills
  • Arthralgia
  • Malaise
  • Anorexia
  • Nausea
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16
Q

What are the investigation findings for generalised pustular psoriasis?

A
  • FBC
  • Elevated Inflammatory markers
  • Hypoalbuminaemia
  • Abnormal LFTs
  • No microbial growth from cultures of pustules or blood
17
Q

What will an FBC show in generalised pustular psoriasis?

A
  • Raised WCC
  • Marked rise in neutrophils
  • Fall in lymphocytes
18
Q

What are the differentials for generalised pustular psoriasis?

A
  • Drug eruptions
  • Sepsis
  • Palmoplantar pustulosis
19
Q

What is palmoplantar pustulosis?

A

A localised form of pustular psoriasis

20
Q

When should patients with generalised pustular psoriasis be admitted to hospital?

A

Immediately, it is a life threatening emergency 🚨

21
Q

What supportive therapy is needed in generalised pustular psoriasis?

A
  • Hydration
  • Fluid and electrolyte balance
  • Nutrition
  • Temperature regulation
22
Q

What can assist in soothing and debriding areas affected by generalised pustular psoriasis?

A

Bland topical compress or saline or oatmeal baths

23
Q

What specific medications can be useful in generalised pustular psoriasis?

A
  • Oral retinoids
  • Systemic corticosteroids
  • Methotrexate
  • Ciclosporin
  • Colchicine
  • Biological therapies
24
Q

What are the potential complications of generalised pustular psoriasis?

A
  • Secondary bacterial infection of the skin
  • Nail loss
  • Hypoalbuminaemia
  • Renal tubular necrosis
  • Liver damage
  • Malabsorption and malnutrition
  • Death
25
Q

Why can hypoalbuminaemia occur in generalised pustular psoriasis?

A

As a result of loss of plasma protein in tissues

26
Q

What can cause renal tubular necrosis in generalised pustular psoriasis?

A

Reduced circulating volume

27
Q

What can cause liver damage in generalised pustular psoriasis?

A

Poor circulation and general toxicity

28
Q

What can cause death in generalised pustular psoriasis?

A
  • Cardiac failure
  • Sepsis
  • Acute respiratory distress syndrome

4: Y4 - Dermatology [3] (26 decks)

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