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Carolyn's lectures > Eczma and Psoriasis > Flashcards

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
Q

Tacrolimus & Pimecrolimus has little systemic effects but is metabolised by CYP3A4. true or false?

A

true

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26
Q

What are the ADRs with Tacrolimus & Pimecrolimus?

A
  • Can cause burning and prunitus
27
Q

What are the cautions Tacrolimus & Pimecrolimus?

A
  • increases risks of skin cancer
  • avoid Uv light
  • increases risk of skin infection
28
Q

What are the drug interactions with Tacrolimus & Pimecrolimus?

A
  • interacts with immunosupressants
29
Q

Tacrolimus & Pimecrolimus is contraindicated with skin barrier defects and hypersenisitivity. TRUE OR FASLE?

A

TRUE

30
Q

Ciclosporin is used for the treatment of both eczma and psoriasis. TRUE OR FALSE?

A

TRUE

31
Q

Ciclosporin is an older calcinuerin inhibitor but has significant amounts of ADRs. TRUE OR FLASE?

A

TRUE

32
Q

Ciclosporin has F p.o 30% and t1/2 of 18 hrs. TRUE OR FALSE?

A

TRUE

33
Q

what are the ADRs of Ciclosporin?

A
  • Nephrotocixity, infections, hyeprtension
34
Q

Cautions of Ciclosporin include avoid with UV light, manage renal function and infection. TRUE OR FLASE/

A

TRUE

35
Q

what are the drug interactions with Ciclosporin?

A

avoid with immunosupressants

36
Q

Methotrexate is used for treatment of sever psoriariss and it is also an antimetabolite used to treate cancer. TRUE OR FLASE?

A

TRUE

37
Q

Methotrexate inhibits dihyrofolate. TRUE OR FALSE?

A

TRUE

38
Q

What is the mechanism fo action of methotrexate in psoriasis?

A
  • It is unclear but suggestions inlude:
  • decrease in nucleotide synthesis
  • This decrease in adenosine has anti-inflammatory effecst
39
Q

Methotraxate causes bone marrow supresssion ad blood dyscrasia. TRUE OR FALSE?

A

TRUE

40
Q

How is Methotraxate eliminated?

A
  • Tubular secretion by OAT3
41
Q

What are the ADRs of methotrexate?

A
  • Nephrotoxicity
  • heoatoxicity
  • infection
  • Gi uleceration
  • Blood count
42
Q

What are the cautions of methoxtrate?

A
  • Patients with imapired liver function
  • Blood disorders
  • GI ulceration
43
Q

Is there a drug intteraction between NSAIDs and methotrexate?

A

yes

44
Q

how do NSAIDS interact with methotrexate?

A
  • NSAIDS inhibit tubular secretion

- both methotrexate and NSAIDs compete for OAT3

45
Q

methotrexate also has drug interactions with antiflorate antibiotics e.g trimethoprim. TRUE OR FLASE?

A
  • TRUE
46
Q

Antifolate antibiotics inhibit folate synthesis which alos has additive toxicity (methotratxate also inhibits folate synthesis). TRUR OR FLASE?

A

TRUE

47
Q

Name the different types of steriods and what ecah dose with some examples?

A
  • 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
Q

glucocorticosteriods inhibit inflammatory expression. TRUE OR FLASE?

A

TRUE

49
Q

Glucocorticosteriods

  • Induce anti-inflammatory gene expression
  • Inhibit leukotrine synthesis
  • Inhibit leukocyte migration and activity
  • Inhibit T lymphocyte proliferation. TRUE OR FLASE?
A

TRUE

50
Q

topical glucocorticosteriods is frst line therapy for atopic dermatitis (eczma). TRUE OR FLASE?

A

TRUE

51
Q

glucocorticosteriods for atopic eczma has anti-inflammtory properities, causes vasocnstriction, inhibits keratinocyte proliferation . TRUE OR FLASE?

A

TRUE

52
Q

what are the 4 classes of glucocorticosteriods for atopic dermatitis?

A
  • Mild
  • Moderate
  • Potent
  • Very potent
53
Q

what are some ADRs of glucocorticosteriods?

A
  • 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
Q

what are some ADRS with topical application of glucocorticosteriods?

A
  • Acne

- Skin thinning

55
Q

What do retinoids do?

A
  • They normalise abnormal growth and differentiation in the keratinocytes
56
Q

Alitretinoin is used for eczma treatment. TRUE OR FALSE?

A

TRUE

57
Q

Tazoretene is used for severe psoriasis. TRUE OR FLASE?

A

TRUE

58
Q

Retionoids are teratogenic. TRUE OR FALSE?

A

TRUE

59
Q

Calcitriol is not an active metabolite of vitamine. true or false?

A

false

60
Q

TNFa inhibiotrs are used for severe psoriasis when systemic therapy has not worked. true or false?

A

true

61
Q

name some examples of TNFa inhibitor drugs?

A
  • Etanercept - humanised antibody
  • Infliximab - chimeric antibody
  • Adilumimab - human IgG
62
Q

IL 12 and IL23 inhibitors are involved in NK and T cell activation. TRUE OR FLASE?

A

TRUE

63
Q

provide an example drug of IL 12 and IL23 inhibitors?

A

Ustekinumab

64
Q

IL 12 and IL23 inhibitors have been indicated for sever plaque psoriasis which have not responded to conventioanl systemic therapy. true or false?

A

true

Carolyn's lectures (3 decks)

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