psoriasis

Question 1

what is the aetiology of psoriasis ?

Answer 1

t cell mediated disease
associated with shortening of the keratinocytes
resulting in hyper proliferation in keratinocytes and an increase in cell turn over

Question 2

what is the immune basis of psoriasis pathogenesis ?

Answer 2

Th1
IL-17
IL-22

Question 3

what are the associated co-morbities in psoriasis ?

Answer 3

metabolic syndrome
cardioivascular
disease
depression

Question 4

what is the bimodal age of onset associated with psoriasis ?

Answer 4

type I - youth
Type II - adult

Question 5

what are the triggering factors associated with psoriasis ?

Answer 5

infections ( post streptococcal infection , HIV )
psychogenic stress
weather ( worse in winter )
Drugs ( BASL )
Trauma - koebnerisation
Endocrine - hypocalcaemia
alcohol and smoking

beta blocker
anti malarial
steroid with drawal
lithium

Question 6

what are the types of psoriasis ?

Answer 6

2 PIGE

plaque - vulgaris
guttate
inverse
erythrodermic
pustular ( generalised , localised )

Question 7

what is the distribution of plaque psoriasis ?

Answer 7

extensor surface of the knee and the elbow
scalp
lumbosacral areas
intergluteal clefts
glans penis

Question 8

what are the features of chronic plaque psoriasis ?

Answer 8

chronic well demarcated red/pink plaques
copious silver-white scaling
Koebner’s phenomenon ass itching
Single or multiple lesions
symmetrical on extensor surfaces

Question 9

what is the presentation of inverse psoriasis ?

Answer 9

occurring in skin folds
doesn’t show the scales seen
shiny pink to red sharply demarcated thin plaques

Question 10

what are the nail signs associated with psoriasis ?

Answer 10

pits
onycholysis
subungal hyperkeratosis

Question 11

what are the types of psoriatic arthropathy ?

Answer 11

DIPS
Asymmetrical ( most common )
Axial
Symmetric
Destructive

Question 12

what does guttate mean in latin ?

Answer 12

drop

Question 13

what is the presentation of guttate psoriasis ?

Answer 13

post streptococcal throat infection
young adults
shower of scattered discrete lesions
3mm to 1cm lesions , round or slight oval

Question 14

what are the types of pustular psoriasis ?

Answer 14

localised - palmoplantar
generalized - life threatning

Question 15

what is the presentation of localised pustular psoriasis ?

Answer 15

palmo-plantar
studded with sterile pustules on erythematous base

Question 16

what is the presentation of generalised pustular psoriasis ?

Answer 16

life threatening condition
abrupt onset
fever and tender skin lesions
studded sterile pustules on an erythematous base

Question 17

what is the treatment generalised pustular psoriasis ?

Answer 17

treatment :
admit - ICU if necessary
greasy emollient
IV support
Systemic therapy
Avoid or treat concurrent infection

Question 18

what is the presentation of eryhthrodermic psoriasis ?

Answer 18

generalized erythema and scaling affecting more than 80-90%
systemic affection :
peripheral oedema
tachycardia
fluid and protein loss
hypothermia

Question 19

what are the common causes associated with erythrodermic psoriasis ?

Answer 19

psoriasis
atopic dermatitis
mycosis fungoids
drug reaction

Question 20

what are the dermatological emergencies associated with psoriasis ?

Answer 20

erythroderma psoriasis
generalized pustular psoriasis

Question 21

what is the psoriasis treatment strategy ?

Answer 21

1st line - emollients

2nd line - topical agents
steroids , vitamin D, topical retinoids

3rd line- phototherapy

4th line- systemic agents

5th line- biological agents

Question 22

what are the systemic treatments in psoriasis ?

Answer 22

immunosuppression ( methotrexate, ciclosprine)
retinoids
biologic therapies

Question 23

what are the biological agents ?

Answer 23

monoclonal antibody therapy
Anti-TNF : infliximab , adalimumab
Anti p40 subunit IL-12/23
IL-17
IL-23

Question 24

what drug is contraindicated in psoriasis ?

Answer 24

oral corticosteroids