Psoriasis

Question 1

Aetiology

Answer 1

polygenic

env triggers: drugs, infection, UV light, alcohol abuse, stress

Question 2

What does skin biopsy show?

Answer 2

epidermal hyperplasia and parakeratosis —> reflects the increase in skin turnover

Glandular layer often absent

Dermal: capillary dilation

Question 3

epidemiology

Answer 3

2 peaks of age onset
- early: 16-22 associated with +ve FH

• late: 55-60yrs

Question 4

what drugs can make it worse?

Answer 4

lithium, antimalarials, maybe beta-blockers

Question 5

Presentation of chronic plaque psoriasis?

Answer 5

pinkish red scaly plaques, silver scale seen, esp. on extensor surfaces e.g. knees + elbows

Question 6

Tx of chronic plaque psoriasis?

Answer 6

emollients to hydrate skin
mild to moderate steroids
synthetic vit D3 analogues e.g. calcipotriol
0.05% tazarotene (a retinoid)

Question 7

When can Tx be discontinued?

Answer 7

once lesions have flattened

Question 8

what can be irritant?

Answer 8

tazarotene + calcipotriol

So use in combo with steroid creams

Question 9

prognosis?

Answer 9

most have it for life

80% get remission at times