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Dermatology > Psoriasis > Flashcards

Psoriasis Flashcards

1
Q

What is psoriasis?

A

Sharply demarcated erythematous plaque with micaceous scale

Chronic imune mediated disease

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2
Q

How can psoriasis develop?

A

Polygenic predisposition + environmental triggers

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3
Q

What genes predispose for psoriasis?

A

HLA-Cw6 9 (chromosome 6)

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4
Q

What are the environmental triggers of psoriasis?

A

Infection
Trauma
Drugs
Sunlight

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5
Q

What is the pathogenesis of psoriasis?

A

Keratinocytes become stressed
Activation of dermal dendritic cells (dDCs)
dDCs travel to lymph nodes and present antigen to naive T cells
Interleukins and TBF alpha amplify inflammatory cascade, stimulate keratinocyte proliferation
Angiogenesis
Cell cycle reduced from 28 to 3-5 days

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6
Q

What is found in the histology of psoriasis

A 
Hyperkeratosis 
Neutrophils in stratum corneum 
dilated dermal capillaries 
T cell infiltration 
Acanthosis
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7
Q

What examination should be completed for psoriasis?

A

Skin (Erythroderma, pustules)
Nails (Onocholysis, pitting, oil spots)
Scalp

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8
Q

What is Koebner phenomenon?

A

Surgery scar line can erupt in patient weeks after procedure who has psoriasis

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9
Q

What is the appearance of chronic plaque psoriasis?

A

Symmetric

Extensor surfaces

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10
Q

What can trigger guttate psoriasis?

A

Viral or bacterial infections

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11
Q

Who is commonly affected by guttate psoriasis?

A

Children and adolescents

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12
Q

What areas of the body does palm-plantar psoriasis affect?

A

Palms and soles

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13
Q

What can palms-plantar psoriasis be associated with?

A

Smoking

Sterile inflammatory bone lesions

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14
Q

What is a consequence of scalp psoriasis?

A

Alopecia

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15
Q

What can trigger flexural/inverse psoriasis?

A

Localised dermatophyte, candidate or bacterial infection

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16
Q

What is the appearance of pustular psoriasis?

A

Sterile pustules, sometimes systemic symptoms

17
Q

What can pustular psoriasis associated with?

A

Pregnancy
Rapid stop of steroids
Hypocalcaemia
Infection

18
Q

What is erythrodermic psoriasis also known as?

A

Red man syndrome

19
Q

What is the differential diagnosis of psoriasis?

A 
Seborrhagic dermatitis 
Lichen planus 
Mycosis fungoides 
Bowens disease 
Secondary syphillis 
Contact dermatitis
20
Q

What is the treatment for psoriasis by GP?

A 
Emollients 
Soap substitutes 
Vitamin D3 analogues 
Coal tar creams 
Topical steroid 
Salicylic acid
21
Q

What treatments for psoriasis are managed by dermatologists?

A

Crude coal tar
Dithranol
UVB phototherapy

22
Q

What are the systemic treatments for psoriasis?

A

Retinoid (Acitretin)
Immunosuppression (ciclosporin, methotrexate)
Biologic therapies

23
Q

What is the treatment for eyrthrodermic psoriasis?

A

Admission
Fluid balance
Bloods/ IV access
Thick greasy ointment emollients

24
Q

What is used to monitor the progress of psoriasis?

A

Psoriasis Area Severity Index (PASI)

Dermatology Life Quality Index (DLQI)

Dermatology (11 decks)

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