4th Year Psoriasis Flashcards
precipitating factors for development of psoriasis
stress infection (strep throat > guttate) drugs Koebner's phenomena smoking
what is the risk with prednisolone in psoriasis?
rebound flare
histological findings in psoriasis
parakeratosis
absence of granular layer
expanded prickle cell layer
collections of neutrophils in epidermis (Munro microabscesses)
two categories for psoriasis
- psutular
2. non-pustular
where is pustular psoriasis normally located?
hands and feet
triggers for pustular psoriasis
pregnancy steroid withdrawal infections hypoglycaemia drugs (salicylates, lithium)
complications of pustular psoriasis
hypoalbuminuria
hypocalcaemia
acute RTN
liver failure
management of pustular psoriasis
remove trigger
supportive with emollients, fluids and protein replacement
systemic therapies
systemic therapies used in pustular psoriasis
acitretin
methotrexate
pregnancy= use prednisolone
PUVA
non-pustular psoriasis types
- chronic plaque psoriasis/ psoriasis vulgaris
- guttate psoriasis
- scalp psoriasis
- flexural psoriasis
- palmoplantar psoriasis
- palmoplantar pustulosis
- generalised pustular psoriasis
- erythrodermic psoriasis
describe the appearance of chronic plaque psoriasis
erythematous scaly plaques extensors symmetrical silver scale Auspitz sign Koebner's
describe the appearance of guttate psoriasis
raindrop pattern
younger
post-strep throat
management of scalp psoriasis
olive oil tar shampoos (polytar) coconut oil (cocois)
rarely causes permanent alopecia
describe the appearance of flexural psoriasis
shiny, red, well-demarcated plaques
groin
axilla
inframammary areas
describe the appearance of palmoplantar psoriasis
plaques on palms and soles
painful
thickened
presentation of palmoplantar pustular psoriasis
sterile pustules that fade from yellow > brown
smoking
chronic
describe erythrodermic psoriasis
>90% body SA deteriorating patient hypothermia cardiogenic shock dehydration anaemia hypoproteinaemia
arthritis types in psoriasis
asymmetric oligoarthritic symmetrical polyarthritis distal phalangeal joint disease destructive arthritis axial arthritis
topical treatments for psoriasis
emollients tar preparations (staining) vit D analogues e.g. dononex salicylic acid dithranol (staining, short-contact regimes) topical steroids
why are topical steroids usually avoided in psoriasis?
rebound flare
systemic options for psoriasis
phototherapy for 6-8 weeks? methotrexate (+folic acid) ciclosporin (hypertension, renal impairment) retinoids (teratogenic) biologics
