Psoriasis Flashcards
Psoriasis
Chronic autoimmune condition that causes recurrent symptoms of psoriatic skin lesions
Describe a psoriatic lesion
Dry, flaky, scaly, skin lesions
Raised and rough plaques
Where do psoriatic lesions normally occur
Over the extensor surfaces of the elbows and knees and on the scalp.
Pathophysiology of psoriasis
Rapid generation of new skin cells, resulting in an abnormal build up and thickening of the skin
Types of psoriasis
Plaque
Guttate
Pustular
Erthyrodermic
Plaque psoriasis
Thickened erythematous plaques with silver scales, commonly seen on the extensor surfaces and scalp
Guttate psoriasis
Small raised papules across the trunk and limbs.
Mildly erythematous and slightly scaly
Over time the papules turn into plaques
Who commonly gets guttate psoriasis
Children
What triggers guttate psoriasis
Streptococcal throat infection
Stress
Medication
How long does guttate psoriasis take to resolve
3 - 4 months
Pustular psoriasis
Rare severe form
Pustules form under areas of erythematous skin
Can be systemically unwell
Management of pustular psoriasis
Medical emergency - admission to hospital
Erythrodermic psoriasis
Rare severe form
Extensive erythematous inflamed areas covering most of the surface area of the skin
Skin comes away in large patches (exfoliation) resulting in raw exposed areas
Management of erythrodermic psoriasis
Medical emergency - admission to hospital
Signs suggestive of psoriasis
Auspitz sign
Koebner phenomenon
Residual pigmentation
Auspitz sign
Small points of bleeding when plaques are scraped off
Koebner phenomenon
Development of psoriatic lesions to areas of skin affected by trauma
Residual pigmentation
Pigmentation of the skin after the lesions resolve
Management of psoriasis
Topical steroids
Topical vitamin D analogues (calcipotriol)
Refer to dermatology for:
- Topical calcineurin inhibitors (tacrolimus)
- Phototherapy
- Immunosupressants like methotrexate, azathioprine and ciclosporin
- Biologics
Nail psoriasis signs
Nail pitting
Nail thickening
Nail decolourisation
Ridging
Onycholysis
Complications of psoriasis
Psoriatic arthritis
Nail psoriasis
Mental health implications
Comorbidities associated with psoriasis
CVD Obesity Hyperlipidaemia HTN T2DM
Investigations for psoriasis
Normally clinical diagnosis
Skin biopsy
CVD screen
