Psoriasis Flashcards
What is psoriasis?
A chronic inflammatory condition of the skin characterised by scaly erythematous and pruritic plaques
What are the 5 types of psoriasis?
Chronic plaque psoriasis
Flexural psoriasis
Guttate psoriasis
Pustular psoriasis
Generalised psoriasis
What is chronic plaque psoriasis?
Symmetrical plaques on the extensor surfaces of the limbs, scalp and back
What is flexural psoriasis?
Smooth erythematous plaques without scale in flexures
What is guttate psoriasis?
Multiple small, tear shaped lesions on the trunk after a streptococcal infection in children
What is pustular psoriasis?
Multiple petechiae and pustules on the palms and soles
What is generalised psoriasis?
Psoriasis with erythroderma and systemic illness
What are the risk factors for psoriasis?
Skin trauma
Withdrawal of steroids
Drugs
- NSAIDs
- Beta blockers
- Lithium
- Anti-malarials
Stress
Alcohol
Smoking
Cold/dry weather
Obesity
Family history
What signs are specific to psoriasis?
Auspitz sign
Koebner phenomenon
Residual pigmentation after lesions resolve
What is the auspitz sign?
Small points of bleeding when the plaques are scraped off
What is the Koebner phenomenon?
The development or psoriatic lesions in an area of skin affected by trauma
What is the first line topical treatment of psoriasis?
Topical corticosteroid and topical vitamin D applied at different times
What is the second line topical treatment of psoriasis?
After 4 weeks of first line treatment:
Continue topical treatment of vitamin D and corticosteroid for further 4 weeks
What is the third line topical treatment of psoriasis?
After a further 4 weeks of treatment:
Stop topical corticosteroid
Apply vitamin D preparation twice daily
What is the first line systemic treatment of psoriasis?
Methotrexate
What is the second line systemic treatment of psoriasis?
Ciclosporin
What biologics can be used to treat psoriasis?
Infliximab
Etanercept
Adalimumab
What nail changes are seen in psoriasis?
Nailbed pitting
Onycholysis - separation of nail from nailbed
Subungual hyperkeratosis - thickening of nailbed
What is the most common type of psoriasis?
Chronic plaque psoriasis
How long should be left between courses of topcial corticosteroids?
4 weeks
What therapy is given for psoriasis before trialling systemic oral therapies?
Phototherapy 3 times a week
What is the management of guttate psoriasis?
Reassurance
Topical corticosteroid if symptomatic
What is the presentation of guttate psoriasis?
Teardrop papules on the trunk and limbs
