Psoriasis Flashcards
Histology of psoriasis?
Aconthosis nigricans, munro microabscesses, elongation of rete ridges, suprapapillary thinning.
Prevalence of psoriasis?
2%, racial variation! affects men and women equally.
Common aggravating factors of psoriasis?
Strep throat, medications (B blockers, lithium, antimalarials), stress, alcohol, smoking, trauma, sunlight
Features of chronic plaque
Salmon pink patches Demarcation Silvery scales Extensor surfaces Symmetrical Nail changes, pitting, nail bed away, hyperkeratosis Koebner phenomenon Auspitz sign
Signs of guttates psoriasis?
Mor common in children Acute strep infection Rain drop lesions Self resolving May precede chronic pulque psoriasis
What is erythrodermic psoriasis ?
90% body affected
Uncommon
Preceding history of psoriasis
May be systemically ill. (Dehydration, hypothermia, renal failure! cardiac failure)
What percentage have psoriatic arthropathy?
10%
3 main symptoms of psoriasis?
Bleeding
Itch
Pain
6 first line treatments for psoriasis?
Emollients Vit D3 analogues Topical steroids Keratolytics (salicylic acid) Coal tar Dithranol
Example of d3 analogue?
Calcipotriol
What should be used for a thick plaque?
Keratolytics,dithranol
2nd line?
Phototherapy
UvB
PUVA- psoralen plus UVA (psoralen makes skin more sensitive to light)
Side effects of PUVA?
Erythema, pruritis, nausea, skin cancer
3rd line?
Systemic methotrexate for psoriasis and arthropathy. S/E TERATOGENIC NAUSEA GI UPSET LIVER FIBROSIS MARROW SUPPRESSION
Other 3rd lines?
Ciclosporin
Acitretin
