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Eczma and Psoriasis Flashcards

1
Q

what is eczma?

A
  • It is the inflammation of the skin

- Also known as dermatitis

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2
Q

What are the characterisation of eczma?

A
  • Itching
  • Lesions
  • Blisters
  • This can lead to infections
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3
Q

where is eczma most commonly founf in the body?

A
  • Face
  • Neck
  • Back of the knee
  • Inside of arm
  • Wrists
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4
Q

what is the process of eczma occuring?

A
  • Oedema and inflammatory cell inflitration
  • spongosis and fluid filled vesciles
  • Scaling
  • Epidermal hyperplasia
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5
Q

What are the 5 types of dermatitis (eczma) and what are their causes?

A
  • primary irritant dermatitis - caused by chemicals
  • Photoeczmatous dermatitis - caused by UV light
  • Atopic dermatitis - most common and caused by emotional triggers i.e inheritble
  • Allergic contact dermatitis- caused by topically applied antigen
  • drug related eczmatous dermatitis - caused by system drug response
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6
Q

Langerhans cells function as an antigen presenting cell. TRUE OR FALSE?

A

TRUE

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7
Q

Describe the mechanism of action of contact dermatitis?

A
  • Langerhans cells present antigen
  • This activates the naive T cells in the lymph nodes
  • This differentiates into memory T cells and Effector T cells
  • Memory cells in the skin recognise antigen in re-exposure
  • Cytokine release causes activation of effector T cells
  • Vascular endothelium actiavtion causes further effector T cell recrutiment
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8
Q

What is psoriasis?

A
  • It is red lesions accompanied by the skin forming silver flakes
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9
Q

where is psoriasis most commonly found?

A
  • scalp

- Back of elbow and knee

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10
Q

Psoriasis - the root is not well understood but there is an elements of iflammation, not contagious and there maybe heritable components. TRUE OR FALSE?

A

TRUE

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11
Q

Psoriasis is a chronic condition that is curable. true ior false?

A

FALSE

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12
Q

In psoriasis you can get dilation of capillaries and lymphocyte infiltration. TRUE OR FALSE?

A

TRUE

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13
Q

What are the pharmacotherapy for ezcma?

A
  • Mild eczma: emollients and mild steriods
  • moderate: emollients and moderate steriods, antihistamines - can also give topical calcineurin inhibitors
  • Severe: emollients, potent steroids, ciclosporin
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14
Q

What are the pharmacotherapy for psoriasis?

A
  • Mild - vitamine D analgues, coal tar, emollients,
  • immune modifiers: topical calcinueim inhibitors , ciclosporin
  • Severe: Methotraxate e.g biologics e.g adilumimab
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15
Q

Emollients are used for both eczma and psoriasis. TRUE OR FALSE?

A

TRUE

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16
Q

Emollients provide hydration to the skin but require refrquent application. TRUE OR FALSE?

A

TRUE

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17
Q

provide examples of emollients?

A
  • Parafin oil - caution is that these are flammable

- Aqueuous creams

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18
Q

Coal tar is used for the treatment of psoriasis. TRUE OR FLASE?

A

TRUE

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19
Q

How is coal tar produced?

A
  • produced from the distillation of coal

- It cotains very complex chemical mixtures

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20
Q

Hows does coal tar help reduce skin thickening? -

A
  • It helps reduce itching

- It also contains keralytics hwich break down keratin, this helps in reduce skin thickening

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21
Q

provide an example of coal tar used for tretament?

A
  • cocois oil containing sulfur, salicylic acid or coal tar
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22
Q

When are Tacrolimus & Pimecrolimus used?

A
  • When treatment of eczma with corticosteriods is inadequate or inappropriate
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23
Q

in what severity of eczma are each Tacrolimus & Pimecrolimus used?

A

Tacrolimus : used in moderate to severe eczma

Pimecrolimus : used in midl to moderate eczma

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24
Q

Tacrolimus & Pimecrolimus are both topically administered. TRUE OR FALSE?

A

TRUE

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25
Tacrolimus & Pimecrolimus has little systemic effects but is metabolised by CYP3A4. true or false?
true
26
What are the ADRs with Tacrolimus & Pimecrolimus?
- Can cause burning and prunitus
27
What are the cautions Tacrolimus & Pimecrolimus?
- increases risks of skin cancer - avoid Uv light - increases risk of skin infection
28
What are the drug interactions with Tacrolimus & Pimecrolimus?
- interacts with immunosupressants
29
Tacrolimus & Pimecrolimus is contraindicated with skin barrier defects and hypersenisitivity. TRUE OR FASLE?
TRUE
30
Ciclosporin is used for the treatment of both eczma and psoriasis. TRUE OR FALSE?
TRUE
31
Ciclosporin is an older calcinuerin inhibitor but has significant amounts of ADRs. TRUE OR FLASE?
TRUE
32
Ciclosporin has F p.o 30% and t1/2 of 18 hrs. TRUE OR FALSE?
TRUE
33
what are the ADRs of Ciclosporin?
- Nephrotocixity, infections, hyeprtension
34
Cautions of Ciclosporin include avoid with UV light, manage renal function and infection. TRUE OR FLASE/
TRUE
35
what are the drug interactions with Ciclosporin?
avoid with immunosupressants
36
Methotrexate is used for treatment of sever psoriariss and it is also an antimetabolite used to treate cancer. TRUE OR FLASE?
TRUE
37
Methotrexate inhibits dihyrofolate. TRUE OR FALSE?
TRUE
38
What is the mechanism fo action of methotrexate in psoriasis?
- It is unclear but suggestions inlude: - decrease in nucleotide synthesis - This decrease in adenosine has anti-inflammatory effecst
39
Methotraxate causes bone marrow supresssion ad blood dyscrasia. TRUE OR FALSE?
TRUE
40
How is Methotraxate eliminated?
- Tubular secretion by OAT3
41
What are the ADRs of methotrexate?
- Nephrotoxicity - heoatoxicity - infection - Gi uleceration - Blood count
42
What are the cautions of methoxtrate?
- Patients with imapired liver function - Blood disorders - GI ulceration
43
Is there a drug intteraction between NSAIDs and methotrexate?
yes
44
how do NSAIDS interact with methotrexate?
- NSAIDS inhibit tubular secretion | - both methotrexate and NSAIDs compete for OAT3
45
methotrexate also has drug interactions with antiflorate antibiotics e.g trimethoprim. TRUE OR FLASE?
- TRUE
46
Antifolate antibiotics inhibit folate synthesis which alos has additive toxicity (methotratxate also inhibits folate synthesis). TRUR OR FLASE?
TRUE
47
Name the different types of steriods and what ecah dose with some examples?
- corticosteriods - from anrenal coretx steriods- these regulate protein and carbohydrate metabolism e.g glucocorticosteriods and also have anti-inflammatory proeprties - mineralcorticosteriods - control fluid and elecrtolyte balance e.g aldosterone - Sex steriods e.g androgens , testesterone, eostrogen (estradiol) - Cholesterol - for membrane fluidity
48
glucocorticosteriods inhibit inflammatory expression. TRUE OR FLASE?
TRUE
49
Glucocorticosteriods - Induce anti-inflammatory gene expression - Inhibit leukotrine synthesis - Inhibit leukocyte migration and activity - Inhibit T lymphocyte proliferation. TRUE OR FLASE?
TRUE
50
topical glucocorticosteriods is frst line therapy for atopic dermatitis (eczma). TRUE OR FLASE?
TRUE
51
glucocorticosteriods for atopic eczma has anti-inflammtory properities, causes vasocnstriction, inhibits keratinocyte proliferation . TRUE OR FLASE?
TRUE
52
what are the 4 classes of glucocorticosteriods for atopic dermatitis?
- Mild - Moderate - Potent - Very potent
53
what are some ADRs of glucocorticosteriods?
- Causes inhibition of pituitary - weight gain and diabetes mellitus - Fat redistribution - broken in some tissues and distributed in other - hypertention - braond- anti-inflammatory effects
54
what are some ADRS with topical application of glucocorticosteriods?
- Acne | - Skin thinning
55
What do retinoids do?
- They normalise abnormal growth and differentiation in the keratinocytes
56
Alitretinoin is used for eczma treatment. TRUE OR FALSE?
TRUE
57
Tazoretene is used for severe psoriasis. TRUE OR FLASE?
TRUE
58
Retionoids are teratogenic. TRUE OR FALSE?
TRUE
59
Calcitriol is not an active metabolite of vitamine. true or false?
false
60
TNFa inhibiotrs are used for severe psoriasis when systemic therapy has not worked. true or false?
true
61
name some examples of TNFa inhibitor drugs?
- Etanercept - humanised antibody - Infliximab - chimeric antibody - Adilumimab - human IgG
62
IL 12 and IL23 inhibitors are involved in NK and T cell activation. TRUE OR FLASE?
TRUE
63
provide an example drug of IL 12 and IL23 inhibitors?
Ustekinumab
64
IL 12 and IL23 inhibitors have been indicated for sever plaque psoriasis which have not responded to conventioanl systemic therapy. true or false?
true

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