papulosq ds Flashcards
Genes & Chromosomes associated with Psoriasis
HWA CW6 - early onset psoriasis
HLA B27 - Psoriatic Spondylitis
PSORS1 gene - Chromosome 6 - 50% risk
Psoriasis worsening drugs
Antimalarials
Lithium
Beta blockers
NSAIDs
Systemic steroids
Psoriasis worsening infections
Group A beta hemolytic streptococci - guttate psoriasis
HIV
Epidermal transit time (normal vs psoriasis)
28days ➡️ 3-5days
Psoriasis types
Plaque psoriasis - mc
Guttate - child, pharyngitis, macrolides
Pustular - sheets/lakes of pus
Acute form of generalised psoriasis
Von Zumbusch type
Xray of Psoriatic arthritis
Pencil in cup appearance
Psoriatic arthritis classically involves __ joint
DIP
Mechanism of phototherapy in psoriasis treatment
Increases anti-inflammatory cytokines
DOC for pustular psoriasis
Acitretin (oral retinoid)
Role of systemic steroids in psoriasis
Sys steroids are c/i in psoriasis, except Pustular psoriasis of Pregnancy (impetigo herpetiformis)
2nd DOC - Cyclosporine
Triggers of Lichen Planus
Dental amalgam (m/imp)
Hep C, Hep B
Anti-malarials
6 P’s
PRURITIC
Purple
Polygonal
Plain top
Papules & Plaques
Distribution of LP
Flexor surfaces
Changes in LP of nail; mc and m/characteristic
Thinning of nail plate - mc
Pterygium of nail - m/char
Absence of nail plate (anonychia)
LP - hair
Scarring alopecia, showing perifollicular blue grey hue
Histopathology of LP
Hyperkeratosis of SC
Wedge shaped Hypergranulosis of SG
Acanthosis of SS
Necrotic keratinocytes
Pytriasis rosea course
Mother/herald patch ➡ Oval/Secondary patches ➡ Pigmentary changes ➡ Resolves in 4-6wks
Pytriasis rosea distribution
Christmas tree pattern:
Long axis: Down and out from spine, parallel to ribs along lines of Langer
Treatment of Pytriasis rosea
Counsel pt (4-6wks)
Itchy lesions - steroids, anti-histamine
Recalcitrant - Narrow band UV-B phototherapy (311+/-2nm)
Pytriasis rubra pilaris
Follicular papules around hair follicles ➡ Progresses to orange red erythema in cephalocaudal direction
Erythroderma (>90% bsa involved)
Spl ftr: Erythroderma + Islands of sparing
Treatment of choice for Pytriasis rubra pilaris
Acitretin (Oral retinoids)
