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PaedsY5 Derm > Psoriasis > Flashcards

Psoriasis Flashcards

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Dermatology Board Prep flashcards
1
Q

What is Psoriasis?

A

An immune mediated inflammatory disease

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2
Q

What are the types of psoriasis?

A

Guttate
Chronic Plaque
Scalp
Palmo-plantar
Flexural (reverse)
General Pustular

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3
Q

Why does Psoriasis happen?

A

There is immune interaction of Th1/ Th17 cells with dendritic cells and keratinocytes.

There is increased keratinocyte shedding.

There is formation of inflamed plaques.

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4
Q

Who is affected by psoriasis?

A

2-4% of males and females
age 15-25 or 50-60

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5
Q

What is associated with psoriasis?

A

Smoking and alcohol
Psoriatic arthritis
Metabolic syndrome/ NAFLD
Depression
CVS disease

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6
Q

What are the clinical features of plaque psoriasis?

A

Well demarcated
Silvery- white scales
Erythmatous
Plaques
Extensor surfaces affected (also can be scalp, nails, hands, feet and trunk)

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7
Q

What scoring system helps to decide whether to use biologics?

A

PASI (if >10 and 2 systemics tried)

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8
Q

How is psoriasis diagnosed?

A

Clinical

Use PASI/ DLQI/ BSA/ PEST to determine pathway

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9
Q

What is the management of Chronic Plaque psoriasis?

A

Lifestyle changes (smoking/ alcohol cessation)
Topical steroids (stronger for palmoplantar)
Topical tacrolimus/ ciclosporin
Vit D analogues, emollients
Narrowband UVB
PUVA (Psoralen + UVA)
Systemic treatments
Biologics

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10
Q

Which biologics can be used?

A

Infliximab (anti TNF alpha)
Ustekinumab (Anti IL-12 and Il-23)
Secukinumab (anti IL17A)

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11
Q

What is the best treatment of Guttate psoriasis?

A

Pen V if strep throat related
Phototherapy

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12
Q

Which forms of psoriasis cannot be treated with phototherapy?

A

Genital
Flexural

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13
Q

What do you tell someone who has psoralen?

A

Cover up due to increased sunburn risk

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14
Q

How do you treat erythrodermic psoriasis?

A

Admit patient
2 hourly paraffin to re establish barrier
Moderate steroids BD/ ciclosporin
Fluids
Septic screen

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15
Q

What systemic treatments can be used and what are their main side effects?

A

Methotrexate (liver/ lung fibrosis)
Ciclosporin (kidney damage, gum hyperplasia, neuropathy)
Acitretinin (LFT dysfunction and dyslipidaemia)

Need blood test monitoring

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16
Q

How do you treat generalised pustular psoriasis?

A

Stop phototherapy/ steroids if that is the cause
Use infliximab (IV every 6-8wks)
Ciclosporin

17
Q

What is the inherited form of pustular psoriasis?

A

Monogenic IL36R mutation treated with anakinra (IL-1 antagonist)

18
Q

How do nails get affected?

A

Onycholysis
Pitting
Subungual hyperkeratosis

19
Q

What is koebners phenomenon?

A

Psoriasis at site of injury

20
Q

Describe and diagnose this lesion

A

A shower of small, pink-red, scaly ‘raindrops’

Psoriasis

21
Q

Describe and diagnose this lesion

A

Small to large, well-demarcated, red, scaly and thickened areas of skin. It most likely to affect elbows, knees, and lower back but may arise on any part of the body.

Plaque psoriasis

22
Q

Desceribe and diagnose this lesion

A

red scaly thickened patches (plaques) affecting the scalp.

23
Q

Describe and diagnose this lesion

A

Generalised redness of the skin with sloughing

Erythrodermic psoriasis

24
Q

Describe and diagnose this lesion

A

Well-circumscribed, red, scaly, plaques

Patchy or generalised thickening and scaling of the entire surface of palms and/or soles without redness (an acquired keratoderma)

Palmoplantar psoriasis

25
Q

Describe and diagnose this lesion

A

red scaly and thickened patches of skin localised to the skin folds and genitals

Flexural (inverse) psoriasis

26
Q

Describe and diagnose this lesion

A

widespread sterile pustules on a background of red and tender skin

Generalise pustular psoriasis

PaedsY5 Derm (5 decks)

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