Papulosquamous Diseases

Question 1

Where is psoriasis typically located?

Answer 1

• extensor surfaces of elbows & knees

- scalp

Question 2

Describe psoriasis

Answer 2

• chronic, inflammatory condition

- epidermal proliferation that results in thickened stratum corneum

Question 3

When is psoriasis usually diagnosed?

Answer 3

• 3rd decade

Question 4

Describe the signs and symptoms of psoriasis

Answer 4

• well demarcated erythematous plaque with a silvery scale

- raised

Question 5

What is the etiology of psoriasis?

Answer 5

• unknown

Question 6

Describe genetic rate of psoriasis

Answer 6

• 50% of patients with psoriasis also have family hx

Question 7

What is the most common type of psoriasis?

Answer 7

• plaque

Question 8

What can cause guttate psoriasis or worsen and existing psoriasis?

Answer 8

• streptococcal infection

Question 9

What other events can worsen psoriasis?

Answer 9

• emotional stress
• skin trauma
• drugs
• obesity

Question 10

What is Koebner Phenomenon?

Answer 10

• psoriasis presenting where there was skin injury

- i.e. incision or road rash

Question 11

What can happen to psoriasis plaques?

Answer 11

• fissure

- bleed

Question 12

What other symptoms may occur with psoriasis?

Answer 12

• pruritis
• pain
• arthralgias (i.e. psoriatic arthritis)

Question 13

How does nail psoriasis present as?

Answer 13

• subungal discoloration, often yellow/white

Question 14

nail psoriasis ddx

Answer 14

• onychomycosis (nail fungus)

Question 15

What are the systemic effects of psoriasis?

Answer 15

• psoriatic arthritis
• inflammation
• depression

Question 16

Describe psoriatic arthritis

Answer 16

• same inflammatory process affects the joints

- 30% or patients

Question 17

What is the treatment for psoriasis?

Answer 17

• no cure, only topical steroids

others: calcipotriene, tazarotene, taclonex, tar

Question 18

What is a non-drug treatment for psoriasis?

Answer 18

• phototherapy

Question 19

What are the systemic treatment options for psoriasis?

Answer 19

• methotrexate
• soriatane
• cyclosporine
• biologics

Question 20

Describe the clinical features of PR

Answer 20

• herald patch

- intensely pruritic

Question 21

Describe the herald patch, what disease is it found with

Answer 21

• one large 2-6 cm patch
• round/oval, pink/tan, scaly
• presents 3-7d prior to remainder of sx

Question 22

What does the distribution look like for pityriasis rosea?

Answer 22

• christmas tree

Question 23

What is the treatment for pityriasis rosea?

Answer 23

• time, resolves on its own

- alleviating pruritis via topical steroids, oral antihistamines, or phototherapy

Question 24

Describe the clinical presentation of lichen planus

Answer 24

• pruritic flat topped violacsous (purple) papules
• fine white streaks or grey lines within lesions
• oral erosions or lacy white patches on buccal mucosa
• scarring alopecia
• nail deformity

Question 25

What are wickham’s striae?

Answer 25

• fine white streaks or grey lines within the lichen planus lesions

Question 26

lichen planus ddx?

Answer 26

• drug reactions

Question 27

What is the treatment for lichen planus?

Answer 27

• topical steroids
• systemic steroids (prednisone) for severe cases
• phototherapy
• plaquenil

Question 28

Which of the treatments for lichen planus is an anitmalarial antiinflammatory?

Answer 28

• plaquenil

Question 29

When will lichen planus resolve?

Answer 29

• spontaneously 6m - 2y

Question 30

What can cause flares of lichen planus?

Answer 30

• stress

Question 31

The 4 ps of LP

Answer 31

Pruritic purple polygonal papules