Psoriasis Flashcards
Describe the parameters of early onset of psoriasis
- 16-22 years
- more severe and extensive
- first-degree family member most likely affected
What is the mean age of occurance?
~ 23-37
Describe the parameters of late onset of psoriasis
- 57-60 years
- milder form
- no first-degree relatives affected
Psoriasis is the most prevalent _____________ condition
autoimmune
Does psoriasis affect men or women more?
- It affects them equally.
- Hormones play no role when it comes to psoriasis
What factors play a role in creating an “inappropriate immune response”?
genetic predisposition +/- predisposing factor + precipitating trigger
What are the predisposing factors that can contribute to psoriasis?
- obesity
- alcohol consumption
- smoking
- stress
- viral/bacteria infections (can predispose disease onset or trigger relapse)
What kind of infections can be linked with psoriasis?
- strep throat
- candida albicans
- HIV
- staph infections (boils)
- viral upper respiratory infections
What are the other triggers associated with psoriasis?
- Drugs
- NSAIDS, lithium, beta-blockers - Cold, dry weather
- Skin trauma
What is Koebner phenomenon?
- psoriasis associated with skin trauma
- can occur in area of damage or on other places
- occurs within 7-14 days of dermis damage
- increased change when psoriatic lesions are already present
- injury can be caused by:
- physical injury
- chemical burns
- excessive rubbing
- sunburns
- allergic reaction
What are the physiological roles of the skin?
- barrier to elements and pathogens
- thermoregulator protecting the body from excessive heat loss or overheating
- UV radiation protection
- wound repair and regeneration
- synthesizes vitamin D
What type of skin cell is mainly affected in psorasis?
Where are they found?
- keratinocytes
- key structural material of the stratum corneum (outer skin layer)
- found in epidermis
What are melanocytes?
the skin cells that product pigment
What are Langerhans cells?
The skin cells that detect, attack, neutralize and eliminate foreign bodies
What are merkell cells?
cells involved with the function of touch
Psoriasis is an autoimmune disease mediated by ___________.
T-cells
Explain how T-cells contribute to psoriasis.
- T-cells (Th1 and Th17) are activated by an APC (antigen presenting cell)
- this causes the release of cytokines and chemokines (inflammatory mediators)
- immune system response is induced
- epidermis is flooded with activated T-cells
- activated T-cells induce keratinocyte proliferation, therefore reducing destruction
- this leads to a buildup in skin plaques
Plaques contain _____ more keratinocytes than normal skin
30%
- due to activated T-cells (they induce keratinocyte proliferation)
What is the significance of “rete ridges”?
- they help diagnose psoriasis
What are the major pathogenic changes in psoriasis?
- Epidermal thickening (keratinocyte abnormalities)
- Bright erythema (new blood vessels formation)
- Silvery psoriatic scales (parakeratotic keratinocytes and neutrophil accumulation)
- Elongated “rete ridges”
Why are scented emollients bad for psoriasis?
- they will cause irritation/burning
- causes more keratinocytes accumulation
Name the types of psoriasis
- psoriasis vulgaris (chronic plaque)
- guttate
- flexural
- erythrodermic
- pustular
- palmoplantar
- scalp
- nail
Describe guttate psoriasis
- “drop” psoriasis
- most common in children and young adults
- can occur suddenly or can be caused from infection, stress
- small, red, individual tear drop lesions
- location = limbs, trunk or face
Describe flexural (inverse) psoriasis
- smooth, shiny, inflammed patches
- occurs on flexors surfaces (armpits, groin, underneath breasts, under butt folds)
- can be mistaken for candida infections
