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RB Y2 Dermatology > Psoriasis > Flashcards

Psoriasis Flashcards

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Dermatology Board Prep flashcards
1
Q

define parakeratosis

A

inc in number of nuclei in keratin layer of epidermis (stratum corneum)

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2
Q

define papillomatosis

A

irregular epithelial thickening

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3
Q

what is the most common form of psoriasis

A

psoriasis vulgaris (chronic plaque psoriasis)

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4
Q

define psoriasis

A

chronic inflammatory dermatosis thought to be autoimmune mediated

characterised by well demarcated red, scaly plaques. The skin becomes inflamed and hyperproliferates at about ten times the normal rate

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5
Q

age of onset

A

two peaks

  • younger is more common, and is usually associated with a psoriatic family history
  • older peaks at around around 55-60
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6
Q

aetiology

A

regulation of epidermal turnover lost - hyperplasia . T cell driven inflammatory infiltration of dermis and epidermis

there is a genetic predisposition but it is also dependent on environmental factors

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7
Q

which T cells is psoriasis associated with

A

Th1 and Th17

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8
Q

is there epidermal or dermal involvement?

A

T lymphocyte driven inflammatory infiltration of dermis and epidermis

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9
Q

pathophysiology

A

polymorphs attracted to stratum corneum creating munro micro abscesses.

parakeratosis, acanthosis and thick keratin scale

epidermal rete ridges are elongated and clubbed

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10
Q

where are munro micro abscesses found

A

in the epidermis

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11
Q

what happens to the dermis

A

there is oedema and inflammation

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12
Q

what does the thick keratin scale indicate

A

epidermal involvement

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13
Q

what happens to the keratinocyte turnover time

A

normally 28 days, reduced to 7 days

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14
Q

what are munro micro abscesses

A

collection of neutrophils in the stratum corneum

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15
Q

what happens to the blood vessels

A

thick and tortuous

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16
Q

describe the plaques

A

thick, scaly, sharply demarcated erythematous plaques

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17
Q

symmetrical?

A

yes

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18
Q

what is the koebner phenomenon

  • what diseases is it also seen in
A

new lesions at site of trauma

  • lichen planus and vitiligo
19
Q

what is Auspitz sign

A

removal of surface scale reveals tiny bleeding point due to dilated capillaries in elongated dermal papillae

20
Q

what does sun do to lesions

A

improve them

21
Q

itchy?

A

mildy

22
Q

guttate

A

widespread small plaques on trunk and limbs

23
Q

what is guttate preceded by

A

sore throat with group B haemolytic streptococcus

24
Q

time of onset of guttate psoriasis

A
  • Rash comes on very quickly, use in a couple of days
25
Q

what shape can the guttate plaques be described as

A

tear drop

26
Q
A

palmoplantar pustular

chronic condition with multiple sterile pustules on the palms and soles of feet

27
Q

what does palmoplantar pustular first appear as

A

monomorphic yellow lesions

28
Q

what is a serious life threatening form

A

erythrodermic or widespread pustular - RARE

29
Q

features of erythrodermic

A
  • Features are those of any form of erythroderma (red dry skin all over the body)
30
Q

aetiology of erythrodermic

A
  • Usually occurs in the setting of known worsening or unstable psoriasis, uncommonly is the first presentation of psoriasis
  • May be precipitated by e.g. infection, withdrawal of steroids
31
Q

psoriatic nail disease CF

A

oncholysis, nail pitting, dystrophy, subungal hyperkeratosis

32
Q

subungal hyperkeratosis

A

excessive reproduction of skin cells that accumulate between the nail and the nail bed

33
Q

oncholysis

A

pulling away of nail from bed due to abnormal cell adhesion

34
Q

what is nail pitting due to

A

parakeratotic cells being los from surface

35
Q

what are the treatment choices

A

vitamin D analogues

tar

dithranol

steroid ointments

emollients

phototherapy

IS

immune modulation

36
Q

IS drug

A

methrotrexate

37
Q

vitaminD analogues

A

calcipotriol (Dovonex) and calcitriol (silkis) ointment

38
Q

what effect can emollients have if used regularly

A

anti inflammatory

39
Q

what is this histological feature

A

spongiosis - oedema between keratoinocytes

40
Q

what is this histological feature

A

papillomatosis - irregual epithelial thickening

41
Q

name 3 drugs which aggravate psoriasis

A
  • Beta blockers
  • anti-malarials (hydroxychloroquine)
  • lithium
  • interferons
42
Q

what adverse effect on the skin can steroids cause

A

skin atrophy

43
Q

what adverse effect can dithranol cause

A

skin irritation, particularly of genitalia and eyes

44
Q

which treatment is preferred by patients as it is the cleanest

A

vitamin D analogues

RB Y2 Dermatology (22 decks)

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