Psoriasis Flashcards
Percentage population affected by psoriasis?
3%
Gender spread psoriasis
M=F
Peak age onset psoriasis
Bimodal: 20s and 50s
Condition associated with increased prevalence of psoriasis?
Crohn’s
Pathophysiology psoriasis?
-inflammatory infiltrate
-epidermal hyperproliferation
-vascular proliferation
usually skin cell turnover =20d but in psoriasis = 4-7d so basically have sensitive, friable baby skin cells at surface
What is the most common type of psoriasis?
Chronic plaque psoriais: red, raised heavily scaled symmetric plaques.
- salmon pink classic
- extensors (sacrum, behind ears and scalp etc, nails)
- if flexural, no scaling
- koebnerisation
What are the types of psoriasis?
- Chronic plaque
- Palmoplantar
- Guttate
- Erythrodermic
- Generalised pustular
- Nail psoriasis
What is pustular psoriasis?
- Usually soles of feet
- Sterile pustules
- More common in female smokers
- Quitting smoking doesn’t change incidence
What is guttate psoriasis?
- Younger
- Usu. follows strep infection
- Small spots
- Self resolving
- Not predisposing to later psoriasis
What erythrodermic psoriasis?
- Up to 90% body affected
- In old or young can cause haemodynamic compromise (as so much going to skin)
- Can require urgent medical admission
What are the features of psoriatic nails?
- Pitting
- Onycholysis (plate separating from bed)
- Oil spots (yellowy stains)
Why are oral steroids a poor treatment choice?
Work well but flare when PO steroids ceased
Management of psoriasis?
- Identify triggers (EtOH, smoking, strep throat, drugs)
- Pt education (genetic, lifelong)
- Emollients
- Keratolytics (e.g. salicylic acid)
- Sedating antihistamines for night
- Ointments > creams
Which drugs are ass
- NSAIDs
- Lithium
- CCBs
- Steroid withdrawal
Why are ointments stronger than cream?
Stronger emollient effect allowing greater penetration of active ingredient, despite same concentration of active ingredient
