Psoriasis Flashcards

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1
Q

What is psoriasis?

A

chronic inflammatory autoimmune skin disease

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2
Q

What is epid of psoriasis?

A
  • Common

- Affects around 3.2% of adults

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3
Q

How common is psoriatic arthritis with psoriasis?

A

among people with psoriasis, prevalence of psoriatic arthritis (around 30%)

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4
Q

What are RF for psoriasis?

A
  1. Genetic
  2. Infection
  3. Local trauma
  4. Medications
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5
Q

What are skin lesions like in psoriasis?

A
  1. Erythematous circumcised scaly lesions
  2. Lesions are itchy or painful in moderate and serve psoriasis
  3. Purple silvery plaques
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6
Q

Where are the skin lesions for psoriasis found?

A
  1. On elbows, knees, extensor surface of limbs

2. Scalp and less commonly nails, ears and umbilical region

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7
Q

How common are nail changes is psoriasis?

A
  1. in 40-45% of patients with psoriasis

2. up to 90% with psoriatic arthritis

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8
Q

What are the nail changes like in psoriasis?

A
  1. Pitting
  2. Whitening of the nail
  3. Splinter haemorrhages
  4. Onycholysis (nail lifting up)
  5. Clubbing
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9
Q

What are the DDx of psoriasis?

A
  1. Eczema
  2. Pityriasis rosea
  3. Seborrheic dermatitis
  4. Myocsis fungoides
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10
Q

What are possible investigations for psoriasis?

A

Clinical Diagnosis maybe skin biopsy

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11
Q

What is the management plan for mild or limited psoriasis?

A

topical corticosteroids and/or Vit D analogues

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12
Q

What is the management plan for psoriasis that is moderate or severe and/or extensive?

A
  1. Phototherapy (esp with guttate)

2. Systemic agents

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13
Q

What systemic agents can be used in severe psoriasis?

A
  1. methotrexate
  2. ciclosporin
  3. aciterin
  4. biological agents
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14
Q

What are possible complications of psoriasis?

A
  1. Cardiovascular complications
  2. Psoriatic arthritis
  3. Depression
  4. Lymphoma
  5. Secondary infection
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15
Q

What are the causes for psoriasis?

A
  • genetic – from 60 to 90%
  • immunology
  • infection
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16
Q

What are DDx for onycholysis?

A
  • Psoriasis
  • Fungal infection
  • Trauma
  • Thyrotoxicosis
17
Q

What is psoriatic arthritis?

A

symmetrical arthritis

18
Q

What are subtypes of psoriasis?

A
  1. Plaque psoriasis: most common
  2. Guttate psoriasis
  3. Flexure psoriasis
  4. Pustular AKA palmo-plantar
  5. Erythrodermic
19
Q

What is guttate psoriasis?

A
  1. raindrop plaques

2. often 2 weeks post strep

20
Q

What is flexural psoriasis?

A

body folds (e.g. axilla, going and peri-anal area)

21
Q

What is pustular AKA palmo-plantar psoriasis?

A

plaques/pustules on palms and plantars

22
Q

What are erythrodermic psoriasis?

A
  1. systemic body redness and inflammation
  2. Often temperature dysregulation, electrolyte imbalances
  3. Requires hospitalisation
23
Q

How do you treat pustular psorasis?

A

Acitretin (1st), ciclosporin (2nd)

24
Q

How do you treat guttate psoriasis?

A

Phototherapy (1st), ciclosporin (2nd), methotrexate (3rd)

25
Q

How do you treat psorasis plaques?

A

Topical hydrocortisone