Papulosquamous Disorders Flashcards
What are the most common sites for psoriasis?
Elbows, knees most common
can also occur in trunk, scalp, genitals
What is this?
Psoriasis
What condition does this describe: Thick scaly rash with silvery scale on elbows, knees
Psoriasis
What type of psoriasis covers the entire body and is red/scaly?
Erythrodermic psoriasis
What type of psoriasis primarily affects hands and feet?
Palmoplantar psoriasis
What is this?
Erythrodermic psoriasis
What are the effects of psoriasis on the nails?
Pits, onycholoysis (yellow discoloration)
What is this?
Psoriasis (note nail involvement)
What are the main features of psoriasis histology?
Elongated, thickened epidermis with rapid production of of keratinocytes, thick stratum corneum, proliferation and dilation of blood vessels near the surface
What is the image on the right?
Psoriasis histology (thick epidermis, thick stratum corneum, dilated blood vessels)
What is the age of onset of psoriasis?
It can start at any age of life, sometimes with a genetic factor and sometimes without
What is the pathophysiology ofpsoriasis?
It is an immune mediated condition with hyperproliferation that is driven by a cascade of inflammatory mediators with T cells and overexpression of TNF-alpha, IL-17, and IL-23 cytokines
What other conditions besides psoriasis are also driven by overexpression of TNF-alpha?
Joints: rheumatoid arthritis, psoriatic arthritis
GI system: Chrons disease/ulcerative colitis
What is guttate psoriasis?
A form of psoriasis with smaller, coin sized plaques that is often triggered by preceding sore throat, bacterial strep infection or viral infection
What skin condition can be triggered by a preceding sore throat, bacterial strep infection, or viral infection?
Guttate psoriasis
What is this?
Guttate psoriasis
What are possible triggers for psoriasis?
Streptococci, stress, trauma, drugs (beta blockers, lithium)
What drugs are most likely to trigger psoriasis?
Beta blockers, lithium
What is this? Associated history: several months of lower back stiffness and early morning/periodic swelling of fingers and toes (“sausage fingers”)
Psoriatic arthritis
What is psoriatic arthritis?
A type of immune mediated arthritis that may lead to destructive/disabling arthritis, morning stiffness, and dactylitis
What amount of morning stiffness is associated with psoriatic arthritis?
Stiffness that improves 30 minutes to 1 hour after walking
What cytokines are associated with psoriatic arthritis?
TNF-alpha
What is the treatment for localized psoriasis?
High potency topical steroids (clobetasol, triamcinolone)
What is the treatment for widespread psoriasis?
UV light phototherapy, targeted therapy with TNF-alpha, IL-23, and IL-17 blockers
What is this? Associated history: not itchy, moisturizers are not helping.
Seborrheic dermatitis
What is the appearance of seborrheic dermatitis?
Redness, and thin yellow (waxy) flaking around the nose, eyebrows, beard area, ears, hairline, scalp
What is the cause of seborrheic dermatitis?
Overgrowth of yeast (pityrosporum ovale)
What is the treatment for seborrheic dermatitis?
Antifungal creams, mild topical steroids
What is this? Associated history: preceded by slight fever and cold-like symptoms.
Pityriasis rosea
What is pityriasis rosea?
Oval salmon colored thin macules or patches with thin scale mostly affecting the trunk, acute self resolving process, often begins with a herald patch
What condition often begins with a “herald patch”?
Pityriasis rosea
What condition often presents with a “christmas tree” pattern on the back?
Pityriasis rosea
What is the etiology of pityriasis rosea?
Possible reactivation of HHV 6 or 7
