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Therapy: year 3 > Psorias > Flashcards

Psorias Flashcards

1
Q

what is psoriasis

A

Tcell mediated disease resulting in hyperkeratotic skin disorder (increased cell turnover)

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2
Q

what are some factors that caus psorias

A
  1. Immune systme changes \
  2. hereditary (PSOR1)
  3. Environemntal (trauma, stress and infections)
  4. drugs (beta blockers, antimalarials, steroids, lithium)
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3
Q

What kind of trauma aids in psoriasis development?

A

koebner phenomenon - trauams like getting a bug bite, or a tattoe, or a sunburn)

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4
Q

what kind of infections aid in psorias development

A

strep - guttate psorias

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5
Q

what drugs can aid in psoriases

A

lithium - exacerbate

beta-blockers - induce new onset psoriases

antimaralirs - exacerbate

steroid - when taken away an exacerbate

indomethacin -can exacerbate

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6
Q

comorbidties of psorias

A
  • itching - hydroxyzine
  • arthritis
  • psychiatric disorder (depression)
  • metabolic syndrome
  • other immune disorders (Crohn’s, Ms, etc)
  • malignancies
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7
Q

Tyoes of psoriasis and focus of her lecture

A
  • plaque psoroias (focus)
  • Guttate psoriasis
  • inverse psoriasis
  • pustular psoriasis
    -erythroderma psoriasis
  • palmar /planter psoriasis
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8
Q

what types of psoriasis are medical emergencies

A

-pustular psoriasis
- erythroderma psoriasis

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9
Q

Clinical manifestations

A

plaque-like lesions, silver- white, loosely adherent plaques

auspitz sign

oil spots

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10
Q

efficacy tests

A

PASI - severity

DLQI - QofL

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11
Q

mild classification

A

less than score of 10 on PASI, and DLQI, and BSA

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12
Q

mod- severe classifiaction

A

score more than 10 on BSA, PASI, and DLQI

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13
Q

two phases for tx

A

induction
- rapid induction within 16 wks
- slower induction within 24 weeks

maintenance phase
- monitor at 8 week intervals

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14
Q

how to assess if treatment is sufficient

A

PASI score of less than 50 - mody tx

PASI score between 50-75 - check DLQI if the score is more or less then 5

if less than or equal to 5 then continue with treatment

if more then 5 then modify treatment

if PASI score if 75 or more - continue with treatment

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15
Q

Tc options of therpay

A
  • non-drug
  • topical rx
  • phototherpay
  • systemic rx
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16
Q

non-pharm tx for psoriases

A
  • stress reduction, non-medical moisturizer (fragrances free), avoid irritating chemicals on skin, avoid skin trauma(sunburn), wear loose fitting cotton clothing
17
Q

tx for mild to mod

A

topical

topical + phototherpay

topical and systemic agents

  • always moisture and step down to the lowest possible regimen while maintaining control
18
Q

Tx for mod-severe

A

Systemic +/- topical dna dphototherpay

Biologic (or 2 systemics) +/- topical

biologic +/- other therpaies

  • whle time use mositurizer and use less potent agent to maintain control
19
Q

topical agents

A
  • CS
  • Retinoids
  • vit D analogues
  • crude coal tar or tar distillates
  • salicyclate acid
  • anthrallin
  • immunomodulators
20
Q

Cs options

HD Valiant Drgaons DiG For Helium D/C

A

low potency : hydrocortisone, desonide

medium potency : betamethasone valete, batemethasome dipropirate lotion

high potency: betamethsone dipropriate crem/gel, flucinonide, halocinode

super high potency: betmetasone diproprionte ointment, colobetasol propionate

21
Q

when due I use lowest potency, medium potency, and high potency

A

lowest - face and skin folds

medium - trunk, arms, legs

high - plams, soles, elbows

22
Q

what is a pro of ointments

A

they enhance penetration

23
Q

what is the purpose of proplyene glycol

A

increases rx solubility, and hence increased rx availibilty and potency

24
Q

systemic affects of CS

A
  • cushing
  • addiosn crisis
  • retarded geowth
  • hyerpgkycemia, glaucoma and caratarcts
25
Q

Toppcal retinoids option

A

tazotarone and tretinoin

26
Q

Toppcal retinoids option cons

A
  • drying agent
  • tertagenic
27
Q

vitamin D analogue options

A
  • calciprotol, calciprotreine, calciotriol
28
Q

what are some steroid sparring options?

A

tretinoins, and vit D analogues

29
Q

coal tar charcteristics

A
  • staining
    -unpleseant odor
  • stinging or irrattaing to skin
  • may be photosenitizing
30
Q

anthrlain indication

A
  • for thick skin otherwise highly irritaing
31
Q

anthralin dose

A

0.1%-0.4% - applied to thicker skin can use zinc oxide to protect

1-4%
- can only be applied for 20 mins before it should be wipped off

Therapy: year 3 (14 decks)

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