Derma - Papulosquamous Disorders

Question 1

Papulosquamous disorders

Answer 1

Psoriasis
Lichen planus
Pityriasis rosea

Question 2

A chronic inflammatory papulo-squamous disease of unknown etiology characterized by sharply demarcated, dull red scaly papules and plaques, particularly on the extensor prominences and in the scalp.

Answer 2

Psoriasis

Question 3

Prevalence of psoriasis

Answer 3

1-3 % of population

Question 4

Population affected by psoriasis

Answer 4

Men = women
Siblings and offspring - inc risk
Early onset - less stable, more severe

Question 5

Age of onset peaks at these ages

Psoriasis

Answer 5

20s

50s

Question 6

Once expressed, it is likely to follow a relentless, waxing, and waning course

Answer 6

Psoriasis

Question 7

How many % of ptx with psoriasis have nail involvement

Answer 7

1/3

Question 8

How many % of ptx have psoriatic arthritis

Answer 8

5-8%

Question 9

Clinical types of psoriasis

Answer 9

Plaque psoriasis
Guttate
Psoriasis
Localized pustular psoriasis
Inverse or intertriginous psoriasis
Generalized pustular psoriasis
Erythrodermic psoriasis

Question 10

Nail findings of psoriasis (w/ nail involvement)

Answer 10

Pitting
Oncholysis
Subungual thickening
Oil drop sign
Nail dystrophy

Question 11

Most common form of psoriatic arthritis

Answer 11

Asymmetric oligoarticular (70%)

Question 12

A translucent yellow-red discoloration int he nail bed proximal to onycholysis

Answer 12

Oil drop or salmon patch

Question 13

Sign of partial loss of cells from the surface of the proximal nail matrix

Answer 13

Pitting

Question 14

Rheumatoid factor result of psoriatic arthritis

Answer 14

Negative

Question 15

Tx of psoriasis

Answer 15

Topical therapy (topical steroids, tar, anthralin, vit. A analogue - tazarotene)
Phototherapy - PUVA, Selective UVB therapy (Narrowband UVB)
Systemic therapy - methotrexate, cyclosporine, retinoids

Question 16

Acute or chronic inflammation of mucous membranes or skin characterized by violaceous, shiny, pruritic papules topped with fine white lines (wickham’s striae)

Answer 16

Lichen planus

Question 17

Sites of lichen planus

Answer 17

Flexor surface of wrists
Lumbar region
Shins
Eyelids
Scalp
Buccal mucosa
Tongue
Lips
Nails

Question 18

Scalp lesions of lichen planus are associated with

Answer 18

Alopecia

Question 19

Mnemonic 6P’s of lichen planus

Answer 19

Pruritic
Purple
Polygonal
Peripheral
Papules
Penis

Question 20

Precipitating factor of lichen planus

Answer 20

Severe emotional stress

Question 21

Lichen planus associated with this infection

Answer 21

Hep C

Question 22

Tx lichen planus

Answer 22

Topical or intralesional corticosteroids
Short courses of oral prednisone (rarely)
PUVA for generalized or resistance cases
Oral retinoids for erosive lichen planus in the mouth

Question 23

Acute self-limiting erythematous eruption characterized by red, oval patches, and papules with marginal collarette of scales

Answer 23

Pityriasis rosea

Question 24

Sites affected by pityriasis rosea

Answer 24

Trunk

Proximal aspect of arms and legs

Question 25

Etiology of pityriasis rosea

Answer 25

Viral (probably)

Question 26

Christmas tree pattern

Answer 26

Pityriasis rosea

Question 27

Long axis of lesions follow lines of cleavage producing Christmas tree pattern on the back

Answer 27

Pityriasis rosea

Question 28

Pityriasis rosea starts with a

Answer 28

Herald patch

Question 29

How long does it take for other lesions to precede the herald patch in pityriasis rosea

Answer 29

1-2 weeks

Question 30

When does pityriasis clear up

Answer 30

6-12 weeks

Question 31

Tx pityriasis rosea

Answer 31

No tx needed unless itchy or widespread