Derm- psoriasis

Question 1

what is psoriasis

Answer 1

chronic autoimmune disease characterised by well-demarcated, erythematous, scaly plaques

Question 2

what are the two age peaks in incidences of psoriasis

Answer 2

20s
50s

Question 3

triggers of psoriasis

Answer 3

smoking and alcohol
stress
trauma
infections eg strep throat
drugs- beta blockers, antimalarial drugs, lithium

Question 4

drugs that can trigger psoriasis

Answer 4

beta blockers
lithium
anti-malarial drugs

Question 5

in psoriasis, what do activated T cells produce?

Answer 5

cytokines
IL-17A

Question 6

what is the koebner phenomenon

Answer 6

psoriasis that develops in an area of trauma

Question 7

common sites for psoriasis

Answer 7

knees
elbows
scalp

Question 8

what is lichenification

Answer 8

thickening and hardening of the skin due to chronic scratching/rubbing

Question 9

what is Autpitz sign

Answer 9

bleeding points where surface scale is removed

Question 10

nail changes seen in psoriasis

Answer 10

nail pitting
Onycholysis
Subungual hyperkeratosis- thickening of the nailbed

Question 11

what is guttate psoriasis

Answer 11

multiple small, tear dropped-shaped plaques occur on the trunk after strep in young adults

Question 12

management of guttate psoriasis

Answer 12

reassurance

Question 13

what is Pustular psoriasis

Answer 13

multiple petechiae and pustules on the palms and soles

Question 14

what is seen in the histology of psoriasis

Answer 14

acanthosis- thickened epidermis
parakeratosis- presence of nuclei in keratin layer

Question 15

how long does it take for skin cells to be replaced in a normal individual compared to someone with psoriasis?

Answer 15

normal- 3-4 weeks
psoriasis- 3-7 days

Question 16

first line treatment for psoriasis

Answer 16

potent topical corticosteroid and topical vitamin D applied at different times

Question 17

second line treatment psoriasis

Answer 17

stop topical corticosteroid, apply topical vitamin D twice daily

Question 18

third line treatment psoriasis

Answer 18

stop topical vitamin D, apply topical corticosteroid twice daily

Question 19

where is often the first and only site of psoriasis

Answer 19

scalp

Question 20

example of a potent topical corticosteroid used to treat psoriasis

Answer 20

betnovate

Question 21

example of a topical vitamin D OD used to treat psoriasis

Answer 21

dovonex

Question 22

side effects of ciclosporin (5Hs)

Answer 22

hypertension
hypertrophy of the gums
hypertrichosis
hyperkalaemia
hyperglycaemia (diabetes)

Question 23

which topical treatment contains a corticosteroid and vitamin D in one lotion

Answer 23

Calcipotriol/betamethasone dipropionate (Taclonex)