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OS 212 DERMATOLOGY > Psoriasis > Flashcards

Psoriasis Flashcards

1
Q

Chronic, relapsing, immune related, inflammatory (presence of neutrophils) disease

A

Psoriasis

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2
Q

Onset of Psoriasis

A

usually at 15-30

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3
Q

Layers of the skin affected

A

Inflmmatory cells
thinner stratum granulosum
Hypercellular stratum spinosum

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4
Q

Psoriatic skin

A

increased production of cells, resulting in decreased regeneration time and thickening of epidermis

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5
Q

Classic presentation of psoriasis

A

circumscribed, erythematous plaques covered with thick silvery white scales which may be associated with itching or burning

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6
Q

Normal skin

A

Proliferative Cell population: 27,000 cells/cumm

Cell cycle Duration: 311 hours (13 days)

Epidermal Transit time: 28 days

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7
Q

Psoriatic skin

A

Proliferative cell proliferation: 52,000 cells/cumm

cell cycle duration: 26 hours (1.5 days)

Epidermal transit time: 3-4 days

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8
Q

Etiology of Psoriasis

A

Manifestation of Genetic and environmental factors

Chromosome 6

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9
Q

genetic factors of Psoriasis

A

Multiple genetic oci
HLA: Cw6, B13, B27

Non-HLA: PSORS1-10 cytokine receptor genes

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10
Q

Triggers of Psoriasis

A

STRESS
TRAUMA
INFECTION
DRUGS (Anti-malarials, lithum, beta-blockers)

cold weather
Sunlight
Obesity
Smoking

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11
Q

Type 1 Psoriasis:

A

(+) family history, and is usually associated with HLA-Cw6

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12
Q

Pathophysiology of Psoriasis

A

Autoimmune disease

T-cell mediated (predoinantly Th1 and Th17)

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13
Q

Dendritic Cell and T cell activation and the release of cytokines leads to:

A

Keratinocyte Proliferation with altered differentiation

Plaque formation

Further release of chemokines and cytokines

Leukocyte recruitment

Angiogenesis

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14
Q

Autoimmune T-cell mediated reaction with

A

Over expression of pro inflammatory type 1 cytokines

Inflammation

Vessel dilation and new vessel formation

Lymphocyte and neutrophilic infiltration in the dermis and epidermis

Accelerated epidermopoiesis

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15
Q

RED

A

Angiogenesis and vasodilation

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16
Q

THICK

A

keratinocyte proliferation

17
Q

SCALY

A

Poor keratinocyte differentiation

18
Q

Histological Findings

A 
Hyperkeratosis
Parakeratosis
Dilated capillaries/blood vessels
Neutrophils
Stratum spinosum
19
Q

Due to dermal angiogenesis

Bleeding upon removal of scales atop a thinned suprapapillary plate

due to proximity of surface of dilated tortuous blood vessels found on the tips of dermal papillae

Pain on grasping with thumb

A

AUSPITZ SIGN

20
Q

When scratched, skin produces new lesion

Not exclusive to psoriasis; also present in lichenus planus, verruca vulgaris, vitiligo

Traumatic induction of psoriasis on non lesional skin

Isomorphic response of skin on lines of trauma

A

Koebner Phenomenon

21
Q

Most common morphology of Psoriasis

Extensor surfaces

A

Plaque

-psoriasis vulgaris

22
Q

Smaller drop like plaques with finer scales

Commonly associated with prior streptococcal infection in children and adolescents

23
Q

There are no bacteria and therefore not contagious. Contains neutrophilic infiltrates

A

Sterile Pustules

-will not clear with antibiotics

24
Q

Localized to the digits (acral) portion

may destroyed nailbed

A

Acrodermatitis continua

25
Q

Generalized acute pustular psoriasis

Abrupt onset associated with fever, chils and malaise

Conglomeration of pustuliness

A

von Zumbusch

26
Q

Generalized pustular psoriasis of pregnancy

A

Impetigo herpetiformis

27
Q

End result of a lot of diseases

Scaling is not evident if acute

generalized erythema with or without scaling

A

Erythroderma or Exfoliative Dermatitis

28
Q

Can present with oatmeal-like scales with marked erythema

Initial site involvd in most patients

May extend to anterior or posterior hairline, retroauricular

Scaling not as prominent as in children

A

Scalp Psoriasis

29
Q

Less scaly because the areas are moist

Usual Presentation of infantile psoriasis

Along body folds

A

Flexures, Intertriginous, or inverse

30
Q

Ocassionally occurs alone without other skin sites involved; mistaken as onychomycosis

May be associated with P. arthritis of the DIP joint in the same digit

Onycholysis and pitting rarely occur together

A

Nail Psoriasis

31
Q

Separation of the nail plate from the nail bed

A

Onycholysis

32
Q

Dilated blood vessels and erythema of nail bed; signifies beginning parakeratosis

33
Q

Dilated blood vessels and erythema of nail bed

34
Q

Accumulation of keratin under the nail; opaque appearance

A

Subungual hyperkeratosis

35
Q

Sausage digits

A

Dactylitis

36
Q

Inflammation commonly on achilles tendon bony attachment

A

Enthesitis

OS 212 DERMATOLOGY (9 decks)

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