Papulosquamous Disorders

Question 1

What are the Papulosquamous disorders?

Answer 1

1. Psoriasis
2. Lichen Planus
3. Pityriasis Rosea
4. Pityriasis Rubra Pilaris

Question 2

What is the pathogenesis of Psoriasis?

Answer 2

Autoimmune disorder causing shortening of keratinocyte life cycle from 28 days to 36 hours.

Question 3

What is Koebner Phenomenon?

Answer 3

1. Appearance of lesions along sites of injury

2. Associated with Psoriasis

Question 4

What is Auspitzs sign?

Answer 4

Pinpoint bleeding with removal of scale –> Psoriasis

Question 5

What is Guttate Psoriasis and what is it associated with?

Answer 5

1. Generalized psoriasis

2. Associated with Strep Pharyngitis

Question 6

What is the classic distribution of Psoriasis?

Answer 6

1. Elbows, Knees, Sacrum, Scalp, Palms, Soles

2. Symmetrical

Question 7

What is Acral Psoriasis?

Answer 7

1. Hands and feet only areas involved (80%)

2. See fissures and bleeding

Question 9

What infection is Lichen Planus associated with?

Answer 9

Hepatitis C

Question 10

What is the duration of Lichen Planus?

Answer 10

1. 2/3 of pts have active disease for < 1yr
2. 1/3 clear in the 2nd year
3. Hypertrophic/Acral Lichen Planus may last for decades

Question 11

What does Classic Lichen Planus look like?

Answer 11

1. Dorsal surface of hands/feet
2. Pruritic flat-topped papules
3. Wickham’s Stria

Question 12

What does Hypertrophic/Acral Lichen Planus look like?

Answer 12

1. Shins, plantar surfaces

2. (all bets off!) Nodules, plaques

Question 13

What is something unique to Pityriasis Rosea?

Answer 13

“Herald patch” followed several days later by a generalized eruption with a “Christmas Tree” distribution**

Question 14

What does Pityriasis Rubra Pilaris look like?

Answer 14

Salmon colored patches with islands of sparing