Papulosquamous Diseases Flashcards
Where is psoriasis typically located?
- extensor surfaces of elbows & knees
- scalp
Describe psoriasis
- chronic, inflammatory condition
- epidermal proliferation that results in thickened stratum corneum
When is psoriasis usually diagnosed?
- 3rd decade
Describe the signs and symptoms of psoriasis
- well demarcated erythematous plaque with a silvery scale
- raised
What is the etiology of psoriasis?
- unknown
Describe genetic rate of psoriasis
- 50% of patients with psoriasis also have family hx
What is the most common type of psoriasis?
- plaque
What can cause guttate psoriasis or worsen and existing psoriasis?
- streptococcal infection
What other events can worsen psoriasis?
- emotional stress
- skin trauma
- drugs
- obesity
What is Koebner Phenomenon?
- psoriasis presenting where there was skin injury
- i.e. incision or road rash
What can happen to psoriasis plaques?
- fissure
- bleed
What other symptoms may occur with psoriasis?
- pruritis
- pain
- arthralgias (i.e. psoriatic arthritis)
How does nail psoriasis present as?
- subungal discoloration, often yellow/white
nail psoriasis ddx
- onychomycosis (nail fungus)
What are the systemic effects of psoriasis?
- psoriatic arthritis
- inflammation
- depression
Describe psoriatic arthritis
- same inflammatory process affects the joints
- 30% or patients
What is the treatment for psoriasis?
- no cure, only topical steroids
others: calcipotriene, tazarotene, taclonex, tar
What is a non-drug treatment for psoriasis?
- phototherapy
What are the systemic treatment options for psoriasis?
- methotrexate
- soriatane
- cyclosporine
- biologics
Describe the clinical features of PR
- herald patch
- intensely pruritic
Describe the herald patch, what disease is it found with
- one large 2-6 cm patch
- round/oval, pink/tan, scaly
- presents 3-7d prior to remainder of sx
What does the distribution look like for pityriasis rosea?
- christmas tree
What is the treatment for pityriasis rosea?
- time, resolves on its own
- alleviating pruritis via topical steroids, oral antihistamines, or phototherapy
Describe the clinical presentation of lichen planus
- 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
What are wickham’s striae?
- fine white streaks or grey lines within the lichen planus lesions
lichen planus ddx?
- drug reactions
What is the treatment for lichen planus?
- topical steroids
- systemic steroids (prednisone) for severe cases
- phototherapy
- plaquenil
Which of the treatments for lichen planus is an anitmalarial antiinflammatory?
- plaquenil
When will lichen planus resolve?
- spontaneously 6m - 2y
What can cause flares of lichen planus?
- stress
The 4 ps of LP
Pruritic purple polygonal papules
