psoriasis Flashcards
genes assoc with psoriasis
HLA B13, B17, identical twins
cell pathophysiology psoriasis
T cells stimulate kertatinocytes proliferation
which T cells in psoriasis
Th17, Th1, Th2
chronic plaque psoriasis
well demarcated // red plaques with white scale // extensors, sacrum, scalp
flexural psorasis
skin is smooth
pustular psoriasis
hands and feet
guttate psorasis
transient, small tear trop, psoriatic rash on trunk and limbs
what precipitates guttate psoriasis + how long does it lasts
strep infection 2-4 weeks prior // lasts 2-3 montgs
mx guttate psoriasis
topical psorasis mx // UVB // tonsillectomy
what is koebners phenomenon
skin lesions that appear at site of injury
aside from psoriasis when is koebners phenomenon seen
vitiligo, warts, lichen planus, lichen slcerosis, molluscum
what is auspitz sign
removing a plaque in –> pinpoint bleeding
common nail symptoms psoriasis
pitting, oncholysis, subungal hyperketatosis, loss of nail
what type of psoriasis is most assoc with nail chnages
psoriatic arthroplasty (80-90%)
exacerbating factors psoriasis
trauma, alcohol, meds, withdrawal from steroids
what meds can trigger psoriasis
BB, lithium, alcohol, NSAIDS, chloroquine, ACEi, infliximab
in psoriatic arthropathy what is the first symptoms
unilateral arthritis
1st line mx chronic plaque psoriasis
potent steroid + Vit D analogue (calcipotriol) once daily at different times for 4 weeks
2nd line topical mx chronic plaque psoriasis + when is it offered
no improvement 8 weeks –> Vit D analogue twice a day
3rd line topical mx chronic plaque psoriasis + when is it offered
no improvement 8-12 weeks –> potent steroid BD for 4 weeks OR tar daily OR dithranol
phototherapy for chronic plaque psoriasis
UVB light, photochemotherapy
SE phototherapy
ageing, SCC
systemic therapy chronic plaque psoriasis
1 = methotraxte // others = ciclopsorin, retinoids, infiliximab
mx scalp psoriasis
potent topical steroids OD 4 weeks (betnovate)
mx face, flexure + groin psoriasis
mild or moderate steroid BD 2 weeks
SE topical steroids
atrophy, striae, rebound symptoms
how long after a course of topical steroids can another be started
4 weeks minimum
how long can topical steroids be used
mild - 8 weelks // potent = 4
how long can Vit D analogues be used
long term
when is vit D contraindicated
pregnancy
mechanism vit D
decreased cell division –> decreased epirdermal proliferation
what is Vit D particularly good at in psoriasis
reducing scale (not redness)
downsides tar and dithranol
tar stains + dithranol smells
mechanism dithranol
inhibits DNA synthesis
