Psoriasis

Question 1

Psoraisis clinical presentation

Answer 1

Plaques (well defined)
Symmetrical
Onchylosis 
Red plaques
Inflammatory skin condition (TH1)
Athropathy (in 7% of pt0
Silvery scale
Young patients

• extensor aspect of elbow, knees, scalp and sarcrum
• gutter / pustular variant in young patients

tx: phototherapy- narrow band ultraviolet B

Question 2

what is psoriasis?

Answer 2

a chronic autoimmune conditions that causes recurrent psoriatic skin lesions

genetic component

Question 3

symptoms of psoriasis

Answer 3

dry 
flaky
scaly
faintly erythematous skin lesion
raised and rough plaque

extensor surfaces- elbows, knees, scalp

caused by the rapid generation of new skin cells which results in abnormal build up of thickening of the skin

Question 4

types of psoriasis

Answer 4

1) plaque psoarisis
2) guttate psoriasis
3) pustular psorasis
4) erythrodermic psoriasis

Question 5

plaque psorasis

Answer 5

ickened erythematous plaques with silver scales, commonly seen on the extensor surfaces and scalp.

The plaques are 1cm – 10cm in diameter. This is the most common form of psoriasis in adults.

Question 6

guttate psoriasis

Answer 6

most common in children

many small raised papules across the trunk and limbs. mildly erythematous and can be slightly scaly.

papules in guttate psoriasis can turn into plaques over time.
Guttate psoriasis is often triggered by a streptococcal throat infection, stress or medications. It often resolves spontaneously within 3 – 4 months.

Question 7

pustular psoriasis

Answer 7

a rare severe form of psoriasis where pustules form under areas of erythematous skin. The pus in these areas is not infectious. Patients can be systemically unwell. It should be treated as a medical emergency and patients with pustular psoriasis initially require admission to hospital.

Question 8

erythrodermic psoriasis

Answer 8

rare severe form of psoriasis with extensive erythematous inflamed areas covering most of the surface area of the skin. The skin comes away in large patches (exfoliation) resulting in raw exposed areas. It should be treated as a medical emergency and patients require admission.

Question 9

children vs adults psorasisi

Answer 9

guttate is more common in children and triggered by a throat infection

Auspitz sign refers to small points of bleeding when plaques are scraped off
Koebner phenomenon refers to the development of psoriatic lesions to areas of skin affected by trauma
Residual pigmentation of the skin after the lesions resolve
The diagnosis can be made based on the clinical appearance of the lesions.

Question 10

management of psoriasis

Answer 10

Topical steroids
Topical vitamin D analogues (calcipotriol)
Topical dithranol
Topical calcineurin inhibitors (tacrolimus) are usually only used in adults
Phototherapy with narrow band ultraviolet B light is particularly useful in extensive guttate psoriasis

dovobet
enstilar
^ contains both a potent steroid and vitamin D analogue

Question 11

associations with psoriasis

Answer 11

nail psoriasis - pitting, thickening, discolouration, ridging, onycholysis

psoriatic arthritis

psychosocial- depression/anxiety

Other co-morbidities that increase the risk of cardiovascular disease are associated with psoriasis, particularly obesity, hyperlipidaemia, hypertension and type 2 diabetes.