Psoriasis Flashcards
Psoriasis is defined as a chronic, immune-mediated skin disease with markedly increased _______ cellular turnover
epidermal
What is the most common subtype of psoriasis ?
Plaque psoriasis (about 90% of cases)
- flexural
- nail
- scalp
- palmoplantar
- sebopsoriasis
Most common features of plaque psoriases:
1.
2.
3. sharp borders
- Red plaques
- silver scales
Non-plaque psoriases subtypes:
1.
2. Pustular
3. Erythrodermic
- guttate
Non-drug measures for psoriasis include:
1.
2.
3.
4. occlusive dressings
- avoid triggers
- moisturizer
- humidifier
One of the biggest non-modifiable risk factors for psoriasis is:
Genetics, almost 50% of patients report a family history
Smoking, excessive alcohol
This type of non-plaque psoriasis is characterized by small papules triggered by respiratory infection and appears on trunk, limbs and face
Gutatte
This type of non-plaque psoriasis can cover up to 90% of the BSA and is associated with complications
Erythroderma
First line for MILD plaque psoriasis?
Non-Rx self care
1. Topical steroid mild-medium potency <7 days
adjuncts:
- Petrolatum: to reduce irritation and tachyphylaxis + can allow someone to taper of steroid
- Salicyclic acid: Increases topical steroid penetration
- Lactic acid: 2nd line to SA, safe on large BSA
Common side effects of topical steroids?
1.
2.
- Skin atrophy
- Thinning of skin
Tachyphylaxis, contact dermatitis
Initial options for mild-moderate plaque psoriasis?
1.
2.
- topical steroids
- vitamin D analogues
What is the next option for mild-moderate plaque psoriasis when topical therapy doesn’t work?
Topical + Photo TX
If topical + photo therapy fail for mild-moderate plaque psoriasis, the next step should be?
Topical + systemic agents
First line for moderate to severe psoriasis?
1.
- Systemic agents
+/- topical agent or photo therapy
if those fail, then biologics
Topical retinoid Tazarotene is contraindicated in:
Pregnancy
also avoid on face/folds
This topical drug class is approved for atopic dermatitis but not psoriasis:
Topical calcineurin inhibitors tacrolimus and pimecrolimus
2nd line
This agent used in moderate-severe psoriasis can be useful in psoriatic arthritis:
MTX, also first line of plaque psoriases moderate to severe
Methotrexate is contraindicated in:
1.
2.
Liver Dx
Pregnancy
Contraception for both men and women is required during/3 months post treatment
Cyclosporin is used orally for moderate to severe psoriasis first line for severe pustular or ________
erythrodermic
Cyclosporin for psoriasis should be used for a max of ____ weeks
12
Cyclosporin can cause many side effects:
1.
2.
3. HTN
4. higher risk for squamous and basal cell carcinomas
- Renal Toxicity
- Hypertriglyceridemia
Acitretin (retinoid) is used orally for moderate to severe psoriasis first line for pustular psoriasis or _______
chronic palmoplantar
Acitretinin is contraindicated in:
1.
Pregnancy
In patients of childbearing potential, effective contraception must begin 1 month before beginning therapy with _________ and continue for at least 3 y after discontinuation
acitretinin
