Ch 5 Psoriasis Flashcards
1
Q
Main 2 parts of psoriasis
A
TNF alpha and TH17 T Cells
2
Q
Genetics
A
- Youth is more likely genetic than second peak which is in late adulthood
- PSOR
- MHC-1, TNFa, and HLAcW6
3
Q
Kinetics
A
10 day cycle as compared to 30 day (30% vs 100% in division)
- cGMP,
- Decreased IFNY and STAT1 and NFKB
4
Q
Inflammatory Cytokines
A
- IL-1: ICAM and recruitment
- IL-2: T cell division
- IL-8: Neutrophil and T Cell recuritment
- IL-17
- IL-22
5
Q
Inducers
A
- Trauma (Koebner)
- Infection (GBS) guttate
- Drugs: B blockers, antimalarials
- Hormonal: Improves with preg. Worse with hypoCa
6
Q
Histology
A
- Parakaratosis
- Dermal Vasodilation
- Elongation of rete ridges and thinning of papillae
- T Cells in dermis
- Neuts in Epidermis
7
Q
Kinds
A
- Plaqua
- Guttate: Diff from other papulosquam (GBS)
- Scalp - oily salicylic acid
- Nails: Thimble pits, Onycholysis, hyperkeratosis
- Flexures: Glistening
- Pustular: Generally palmoplantar can be generalized
- Erythrodermic
8
Q
Psoriatic Arthritis
A
- DIP
- Large Joint like RA
- Sacroiliac (B27)
- Enthesis
9
Q
Topical Tx
A
- Vit D
- Tar and Anthralin
- Retinoids
- Steroids
10
Q
UV
A
-UVB (311)
11
Q
PUVA
A
-POMS
Can add retinoids
12
Q
Systemic Non Biologic
A
-MTX: AICAR
-Cyclosporin: Skin Ca/warts, HTN, Renal Failure
-Retinoids;DISH
-
13
Q
Biologics
A
- Etanercept: Soluble TNFa
- Infliximab/Adalimumab: Boud and free TNFa
- Alefacept: CD2 and LFA3
- Efalizumav-LFA 1/ICAM (Thrombocytopenia)
