Psoriasis Flashcards
What is psoriasis?
chronic inflammatory autoimmune skin disease
What is epid of psoriasis?
- Common
- Affects around 3.2% of adults
How common is psoriatic arthritis with psoriasis?
among people with psoriasis, prevalence of psoriatic arthritis (around 30%)
What are RF for psoriasis?
- Genetic
- Infection
- Local trauma
- Medications
What are skin lesions like in psoriasis?
- Erythematous circumcised scaly lesions
- Lesions are itchy or painful in moderate and serve psoriasis
- Purple silvery plaques
Where are the skin lesions for psoriasis found?
- On elbows, knees, extensor surface of limbs
2. Scalp and less commonly nails, ears and umbilical region
How common are nail changes is psoriasis?
- in 40-45% of patients with psoriasis
2. up to 90% with psoriatic arthritis
What are the nail changes like in psoriasis?
- Pitting
- Whitening of the nail
- Splinter haemorrhages
- Onycholysis (nail lifting up)
- Clubbing
What are the DDx of psoriasis?
- Eczema
- Pityriasis rosea
- Seborrheic dermatitis
- Myocsis fungoides
What are possible investigations for psoriasis?
Clinical Diagnosis maybe skin biopsy
What is the management plan for mild or limited psoriasis?
topical corticosteroids and/or Vit D analogues
What is the management plan for psoriasis that is moderate or severe and/or extensive?
- Phototherapy (esp with guttate)
2. Systemic agents
What systemic agents can be used in severe psoriasis?
- methotrexate
- ciclosporin
- aciterin
- biological agents
What are possible complications of psoriasis?
- Cardiovascular complications
- Psoriatic arthritis
- Depression
- Lymphoma
- Secondary infection
What are the causes for psoriasis?
- genetic – from 60 to 90%
- immunology
- infection
What are DDx for onycholysis?
- Psoriasis
- Fungal infection
- Trauma
- Thyrotoxicosis
What is psoriatic arthritis?
symmetrical arthritis
What are subtypes of psoriasis?
- Plaque psoriasis: most common
- Guttate psoriasis
- Flexure psoriasis
- Pustular AKA palmo-plantar
- Erythrodermic
What is guttate psoriasis?
- raindrop plaques
2. often 2 weeks post strep
What is flexural psoriasis?
body folds (e.g. axilla, going and peri-anal area)
What is pustular AKA palmo-plantar psoriasis?
plaques/pustules on palms and plantars
What are erythrodermic psoriasis?
- systemic body redness and inflammation
- Often temperature dysregulation, electrolyte imbalances
- Requires hospitalisation
How do you treat pustular psorasis?
Acitretin (1st), ciclosporin (2nd)
How do you treat guttate psoriasis?
Phototherapy (1st), ciclosporin (2nd), methotrexate (3rd)
How do you treat psorasis plaques?
Topical hydrocortisone
