Psoriasis

Question 1

impt features of Psoriasis (4)

Answer 1

• Non-contagious - Inflammatory skin disease - +/- nail involvement - chronic, without cure

Question 2

Prevalence in PGH

Answer 2

5.5%

Question 3

onset age

Answer 3

15-30

Question 4

Triggers

Answer 4

stress trauma infection Drugs- antimalarials cold weathers sunlight obesity smoking

Question 5

genetic factors

Answer 5

1. HLA Cw6 2 B13 3 B27

Question 6

what does naive T - cells do?

Answer 6

differentiate Th1 and Th17

Question 7

Features of autoimmune disease in psoriasis

Answer 7

1. Autoantigen 2. STreptococcous Ag

Question 8

Pro-inflammatory cytokines produced

Answer 8

Il-2, Il-17,IL-22,Tnf-a,IFNy

Question 9

Keratinocyte kinetics in Psoriasis

Answer 9

1. Proliferative cell population (2x of normal, increase) 2. Cell cycle duration (10% of normal, faster) 3 Epidermal transit time (15% of normal

Question 10

features of blood vessel in Psoriasis

Answer 10

tortuous (causes auspitz sign)

Question 11

Auspitz sign

Answer 11

1. Bleeding upon removal of scales (thinned suprapappilary plate) 2. not always present

Question 12

Koebner Phenomenon

Answer 12

-Traumatic induction of psoriasis of non-lesional skin - NAP -Isomorphic response of skin on lines of trauma

Question 13

identify / with characteristics

Answer 13

• Called a plaque
• Most common
• extensor surfaces
• psoriasis vulgaris

Question 14

morphological variant (name,characteristics)

Answer 14

• Guttate
• Drop-like plaqus with finner scales
• associated with prior streptococcal infection, children and adolescents

Question 15

name and characteristics (name 2 variants and special feature in pregnancy

Answer 15

• Pustular

2 variants - Localized and Generalized (von Zumbusch)

• Impetigo herpitformis (pregnancy)

Question 16

GEneralized erythema without scaling

Answer 16

Eryhtroderma/ exfoliative dermatitis

Question 17

Types of Psoriasis accdg to location

Answer 17

1. Scalp psoriasis
2. Flexures/ intertriginous/ inverse
3. palmoplantar
4. Nail psoriasis
5. Psoriatic arthritis

Question 18

Characteristics of Nail Psoriasis

Answer 18

1. Onycholysis
2. Oil spots
3. Pitting
4. Subungal hyperkeratosis
5. Asssociated with psoriatic arthritis of DIP

Question 19

Sausage digit in psoriatic arthritis

Answer 19

Dactylitis

Question 20

Commonly on the Achilles endon bony attachment

Answer 20

Enthesitis

Question 21

Comorbidities of psoriasis (5)

Answer 21

1. Depression
2. Uveitis
3. IBD

4 MEtabolic syndrome (dys,hpn,ab obesity, diabetis mellitus)

5. CVD => MI => Infarction

Question 22

1 blocks inflammatory mediators

2 Inhibits keratinocytes

3. allows more UV light to interact with hyperproliferative

Answer 22

1. Steroids
2. Calcipotriol and anthralin
3. Tar

Question 23

UV phototherapy

Answer 23

1. UVB, PUVA, (psoralen + UVA)

Question 24

Systemic drugs

Answer 24

Methotrexate, cyclosporine, acitretin