Derm - Psoriasis Flashcards
What is psoriasis?
Chronic autoimmune condition causing recurrent psoriatic skin lesions
What is the genetic relation in psoriasis?
1/3 of patients have a first degree relative with psoriasis
What do psoriatic lesions look like?
Dry
Flaky
Scaly
Silvery raised rough plaques
Extensor surfaces
What are the different types of psoriasis?
Plaque psoriasis
Thickened erythematous plaques with silver scales
Seen on extensor surfaces and scalp
Guttate psoriasis
Many small raised papules across trunk and limbs
Papules mildly erythematous and slightly scaly
Eventually turns into plaques
Pustula psoriasis
Severe rare form, pustules form under areas of erythematous skin
Pus is not infectious
Erythrodermic psoriasis
Rare severe form with extensive erythematous inflamed areas covering most of skin
Skin comes away in large patches causing raw exposed area
Medical emergency
What can cause guttate psoriasis?
Streptococcal throat infection
Stress
Medications
Resolves within 3-4 months
What signs are specific to psoriasis?
Auspitz sign
Small points of bleeding when plaques scraped off
Koebner phenomenon
Development of psoriatic lesions to areas of skin affected by trauma
Residual pigmentation
Of skin after lesions resolve
How is psoriasis treated?
Phototherapy with narrow band UV B light
Steroids
Topical vitamin D analogues (calcipotriol)
Topical dithranol
Topical calcineurin inhibitors (tacrolimus)- adults only
When is phototherapy with narrow band UV B light particularly useful?
Extensive guttate psoriasis
If topical treatments fail to control severe psoriasis what can be done?
Can be started on unlicensed systemic treatment
Methotrexate
Cyclosporine
Retinoids
Biologic medications
What products contain potent steroids and vitamin D analogues that are prescribed but not licensed in children?
Dovobet
Enstilar
What is associated with psoriasis?
Nail psoriasis
Pitting
Thickening
Discolouration
Ridging
Onycholysis (separation from nail bed)
Psoriatic arthritis
10-20% within 10 years
Psychological implications
Mood
Self-esteem
Depression
Anxiety
Increased CVD risk
Obesity
Hyperlipidaemia
Hypertension
T2DM
