Dermatology

Question 1

what is psoriasis, histologically and clinical presentation?

Answer 1

thickening of the epidermis causing multiple areas of red, slightly raised and scaly skin ‘plaques’. Plaques have a clear edge and are often symmetrical. If scratched, they bleed more easily than normal skin. Knees, elbows and scalp are often affected, but all areas can be involved.

Question 2

What are the topical treatments for psoriasis?

Answer 2

Emollients
Topical calcipotriol (a vitamin D analogue)
Topical corticosteroids can be used alone or in combination with calcipotriol.
Topical dithranol (anthralin) is seldom used because it stains the skin (and the clothes) and can cause irritation. However, it is very effective if used carefully.

Question 3

How do you treat widespread psoriasis? 1st, 2nd and 3rd line treatments

Answer 3

1st: Narrow-band UVB or with PUVA
2nd: Oral methotrexate, ciclosporin, acitretin or mycophenolate mofetil.
3rd: Biologics such as infliximab, etanercept, adalimumab or ustekinumab.