Psoriasis Flashcards
What is Psoriasis?
Chronic inflammatory skin condition of autoimmune aetiology due to hyperproliferation of abnormal keratinocytes
What is Chronic Plaque Psoriasis?
Most common subtype
Well demarcated erythematous patches with white/silver scale usually on extensor surfaces
Lesions may appear cracked/fissured if overlying a joint
Scalp normally affected
If scale removed then normally see a red membrane with pinpoint bleeding points (Auspitz sign)
What is Flexural Psoriasis?
Itchy, well demarcated erythematous patches affecting flexures- normally smooth with little to no scale
Often affects inguinal folds, axilla, inframammary fold, perianal region and umbilicus.
What are features of pustular psoriasis?
Affects palms and soles
Can become generalised and rapidly spread across the body
What is the management of CPP?
1) Steroid AND Vit D analoguse (apply different times of day)
- Potent topical steroid e.g. Cutivate or Betnovate
- Topical Vit D OD e.g. caciportriol
2) Review after 4 weeks
- improvement- continue
- no improvement- stop steroid and Vit D analogue BD
3) Review after 4 weeks
- no improvement- potent steroid BD for 4 weeks or coal tar OD or BD
If still no improvement refer to Dermatology
What is the management of Scalp Psoriasis?
1) Prescribe one of
- potent steroid OD for 4 weeks
- Vit D analogue OD
- Coal tar shampoo
2) Combined potent steroid and Vit D
What is the management of flexural psoriasis?
1) Mild to moderate steroid OD-BD for 2 weeks
What are other signs of psoriasis?
Nail signs- pitting, onycholysis
Arthritis
When should Vitamin D analogues be avoided?
In pregnancy
What are features of guttate psoriasis?
More common in children/teens
History of URTI/sore throat approx 2-4 weeks previously
Tear drop lesions on trunk and limbs with overlying scale
What is the management of guttate psoriasis?
Reassure normally self resolves within 2-3 months
If >10% body affected refer to dermatology urgently for UVB photoherapy
Can treat same as CPP
