Psoriasis

Question 1

Describe the clinical classification of Psoriasis

Answer 1

1-Non-pustular psoriasis
Morphology:
i) Plaque type (P.vulgaris) (90%)
ii) Guttat type (Eruptive)
Localisation:
i) Inverse Psoriasis
ii) Scalp Psoriasis
iii) Palmoplantar Psoriasis
2- Pustular psoriasis
3- Erythrodermic psoriasis
4- Psoriatic arthropathy

Question 1

Describe the presentation of plaque type psoriasis, the most affected areas + related phenomenons

Answer 1

a) Sınırları belirgin (well defined), eritematöz plak üzerine micaceous silvery white kalın scale. Simetrik olarak bulunur.
b) En Çok Tuttuğu Yerler: elbows, knees, presacral area, scalp, palms, soles
c) Fenomenler:
Koebner pozitif (appearance of new skin lesions on previously unaffected skin secondary to trauma)
Auspitz’s Sign: psoriatic scale zorla kaldırılınca pinpoint kanamalar olması
Woronoff Ring: concentric blanching of the erythematous skin at or near the periphery of the healing psoriatic plaque (hypopigmented, whitish halo surrounding the erythematous psoriasis lesions)

Question 2

Describe the main characteristica of Guttat type Psoriasis

Answer 2

Guttat type (Eruptive): Much smaller papular lesions with a thinner scale compared to the plaque type. Lesions are quite widespread.
a) Characterized by numerous 0.5 to 1.5 cm papules and plaques
b) Early age of onset
c) Most common form in children
d) Streptococcal throat infection often a trigger, especially in children
i) Genelde strep enfeksiyonu sonrası olduğu için
kan, crp vs ve boğaz kültürü ve aso bakılır
e) Spontaneous remissions in children after the streptococcal infection has been treated with antibiotics
f) Often chronic in adults

Question 3

Describe the different localization of non-pustular psoriasis

Answer 3

Lokalizasyona Göre:
1) Inverse=flexural
a) Mainly in the skin folds (between thigh and groin, intergluteal sulcus, armpits, under an overweight stomach [pannus], under the breasts [inframammary fold])
b) Eritem ve plak var ama scale yok. Friction ve terleme ile artıyor.

2) Scalp:
a) Eritematöz plaklar, beyaz scale ile
b) Marked predilection for frontal scalp margin
c) Absence of itching and hair loss
d) Ddx: seboreik dermatit, superficial tinea capitis

3) Palmoplantar:
a) Kronik plak tip ile birlikte olabilir ya da tek başına palms ve soles’u içerebilir. Bazen tırnak ve eklem de etkilenebilir.
b) Eritem, ragads (cracks in the skin), hyperkeratosis (thickening of skin)
c) It might be aggravated by occupational hazards and trauma

Question 4

Name the different types of Psoriasis + their location & Characteristic Features

Answer 4

check Notion

Question 5

Describe local Tx of Psoriasis

Answer 5

check notion

Question 6

Describe systemic Tx of Psoriasis

Answer 6

check notion

Question 7

Can you give systemic corticosteroid to treat psoriasis

Answer 7

ASLA VE ASLA SİSTEMİK KORTİKOSTEROİD KULLANILMAZ (topikal kortikosteroid ise ana tedavimiz)

Question 8

How to treat psoriasis in pregnant?

Answer 8

Hasta hamileyse ne yapalım? NB-UVB (Narrowband UVB)

Question 9

Tüm vücuda yaygınsa tedavisi nasıldır?; in Psoriasis

Answer 9

Yaygınsa topikal steroid işe yaramaz cyclosporin methotrexate denenebilir daha sonra biyolojik ajanlar verilebilir

Question 10

Describe the nail changes present in Psoriasis

Answer 10

Pitting
Subungual hyperkeratosis
Onycholysis
Yellowish discoloration (=oil drop sign)

Finger nails (%50)
Toe nails (%30)

Question 11

Describe the lesion and list three disorders which are Papullosqumaous disorders

Answer 11

Lezyon: Papül, plak ve scaling.
Papullosqumaous disorders: psoriasis, lichen planus, pityriasis rosea