Psoriasis Flashcards

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1
Q

What is psoriasis

A

Chronic autoimmune disease characterised by well-dermarcated, erythematous scaly plaques

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2
Q

5 Types of psoriasis

A

Chronic plaque psoriasis.
Flexural psoriasis.
Guttate psoriasis.
Pustular psoriasis.
Generalised/erythrodermic psoriasis.

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3
Q

What is chronic plaque psoriasis

A

Commonest type and causes symmetrical plaques on the extensor surfaces of the limbs, scalp and lower back

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4
Q

What is flexural psoriasis

A

Smooth erythematous plaques without scale in flexures and skin folds

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5
Q

What is gluttate psoriasis

A

Multiple small, tear-drop shaped, erythematous plaques occuring on trunk after strep infection in young adults

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6
Q

What is pustule psoriasis

A

Multiple petechiae and pustules on the palms and soles

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7
Q

What is generalised/erythrodermic psoriasis

A

Rare but serious form characterised by erythroderma nad systemic illness

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8
Q

Cutaneous features of chronic plaque psoriasis

A

Itchy, well-dermacated circular-to-oval bright red/pink elevated lesions with overlying white or silvery scale. Distributed symmetrically over extensor body surfaces and scalp

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9
Q

Nail changes in patients with psoriasis

A

Nailbed pitting, onycholysis, subungual hyperkeratosis

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10
Q

Risk factors for tirggering psoriasis

A

Skin trauma, infection (HIV, strep), Drugs, withdrawal of steroids, stress, alcohol and smoking, cold/dry weather

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11
Q

What are the risk f actors for developing psoriasis

A

Fhx, HIV infection, obesity and smoking

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12
Q

What is the Koebner phenomenon

A

Where skin lesions occur at sites of skin injury in otherwise healthy skin. Common psoriasis trigger.

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13
Q

What other diseases cause the Koebner phonomenon

A

Viral warts and vitiligo

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14
Q

Differentials for scaly skin rash

A

Pityriasis rosea, tinea, seborrhoeic dermatitis, Bowen’s disease, Discoid eczema, mycosis fungoides, discoid lupus, scabies

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15
Q

Management of plaque psoriasis

A

Corticosteroids to reduce inflammation.
Vitamin D reduces keratinocyte proliferation.

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16
Q

Management of flexural psoriasis

A

Topical corticosteroid

17
Q

1st line topical optios

A

Potent topical corticosteroid OD (Betnovate) + topical vitamin D OD (Dovonex)

18
Q

2nd ine topical options

A

Stop topical corticosteroid and use vit D topical twice daily

19
Q

3rd line topical options

A

Stop topical vitamin D and apply corticosteroid twice daily

20
Q

Phototherapy options

A

Narrowband UVB photopherapy and then psoralen + UVA

21
Q

Systemic treatments

A

1st line - methotrexate
2nd line - ciclosporin
3rd line - acitretin

22
Q

Biological treatments

A

Infliximab, Etanercept and Adalimumab

23
Q

Topical corticosteroid potencies

A

Mild, moderate, potent and very potent

24
Q

Eg of mild topical corticosteroid

A

Hydrocortisoe 0.5%

25
Q

Eg of moderate topical corticosteroid

A

Eumovate (clobetasone butyrate 0.05%)

26
Q

Eg of potent topical corticosteroid

A

Betnovate (betamethasone valerate 0.1%)

27
Q

Eg of very potent topical corticosteroid

A

Dermovate (clobetasol propionate 0.5%)