PSORIASIS Flashcards
PICTURES
PICTURES
the best characterized T cells are the __ cells
CD4+ and
CD8+ T
__ predominantly located in the epidermis,
whereas __ cells are predominantly located in the upper dermis
o CD8+ EPIDERMIS
o CD4+ UPPER DERMIS
Two other sub-sets of CD4+ T cells, stimulated by IL-23
and characterized by production of IL-17 (Th17 cells) and/or IL-22 (Th22 cells), are also found in psoriatic lesions and have been shown to play a major role in maintaining chronic inflammation in psoriasis
-_-
major producers of IFN-
γ and serve as a bridge between innate and acquired immunity
Natural Killer Cells, NK cells
SIGNALING MOLECULES IN PSORIASIS
Cytokines and Chemokines
The complement component __ is a potent chemoattractant for neutrophils and may
contribute to the accumulation of neutrophils in the stratum
corneum of psoriasis.
C5a
Clinical findings/ history for psoriasis:
- Age of onset
- Presence/absence of family history of psoriasis
Acute is how many weeks?
<6 weeks
if you are going to peel off the scale you will have a pinpoint bleeding underneath the scale
Au spitz sign
ISOMORPHIC RESPONSE
KOEBNER PHENOMENON
is the traumatic induction of psoriasis on non-lesional skin; it occurs more frequently during fares of disease and is all or none phenomenon
KOEBNER PHENOMENON( ISOMORPHIC RESPONSE)
The classic lesion of psoriasis is a __
well-demarcated,
raised,
red plaque with a
white scaly surface
The Koebner reaction usually occurs __ days after injury
7-14 days /
1-2 weeks
Maximum of 2 weeks after you have inflicted the trauma
CLINICAL PATTERNS OF SKIN PRESENTATION/
PSORIASIS IS AKA.
Psoriasis Vulgaris,
Chronic Stationary Psoriasis,
Plaques-Type Psoriasis
the most common form of
psoriasis, seen in approximately 90% of patients
Psoriasis vulgaris
Single small lesion may become confluent, forming
plaques in which the borders resemble a land map
psoriasis geographica
Lesions may extend laterally and become circinate because of the confluence of several plaques
psoriasis gyrate
Occasionally, there is partial central clearing, resulting in ring-like lesion
annular psoriasis
Resembles guttate psoriasis clinically but can be distinguished by its onset in older patients
SMALL PLAQUES PSORIASIS
Psoriasis lesions may be localized in the major skin folds, such as the axilla and genito-crural region, and the neck.
INVERSE (FLEXURAL) PSORIASIS
PICTURES
PICTURES
represents the generalized form of the disease that affects all body sites, including the face, hands, feet, nails, trunk and extremities
ERYTHRODERMIC PSORIASIS
clinical variants of pustular psoriasis
- Generalized pustular psoriasis (von Zumbusch type)
- Annular pustular psoriasis
- Impetigo herpetiformis
variants of localized pustular psoriasis:
- Pustulosis palmaris et plantaris
- Acrodermatitis continua of Hallopeau
“Oil drop sign” or “Salmon patch”
psoriasis physical findings
MIGRATORY TONGUE AKA.
benign migratory glossitis or
glossitis areata migrans
a common extracutaneous manifestation of psoriasis seen in up to 40% of patients
PSORIATIC ARTHRITIS
Laboratory tests in psoriasis patients
- biopsy
- altered lipid profiles
> cholesterol
> sugar
> creatinine
SERUM URIC ACID is elevated in up to 50% of patients
Treatment that regulates skin cell production and
evelopment
Calcipotriene and betamethasone ointment
MEDICATION SUMMARY OF PSORIASIS
- sunshine moisturizers,
and salicylic acid
Treatments for more advanced psoriasis include
narrow-band ultraviolet B (UVB) light
psoralen with ultraviolet A (UVA)
retinoids (e.g., isotretinoin, acitretin)
methotrexate
cyclosporine
Biologics:
infliximab (Remicade)
adalimumab (Humira)
ustekinumab
etanercept (Enbrel)
alefacept (Amevive)
Topical corticosteroids
Keratolytic Agents
salicylic acid
lactic acid
urea
Anthralin
Vitamin D Analogs
Calcitriol ointment
Calcipotriene
Calcipotriene and betamethasone ointment
- regulates skin cell production and
evelopment
