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)
