Psoriasis Flashcards

(36 cards)

1
Q

What is psoriasis?

A

Chronic, immune mediated disease

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2
Q

What are the 2 classes of psoriasis?

A

Type 1- runs in families and is early onset

Type 2- related to autoimmune conditions and environmental triggers and an older population

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3
Q

What causes psoriasis?

A

Polygenic predisposition and environmental truggers

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4
Q

What are the environmental triggers of psoriasis?

A

Infection
Drugs
Trauma
Sunlight

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5
Q

What is the appearance of psoriasis?

A

Sharply demarcated erythematous plaque with micaceous scale

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6
Q

What part pf the immune system os psoriasis associated with?

A

Adaptive immune system

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7
Q

What is the pathogenesis of psoriasis?

A

Stressed keratinocytes cause activation of dermal dendritic cells (dDC) via interleukins and TNFa
dDC= travel to lymph nodes and activate naive T cells to T helper cells that target skin and cause psoriatic dermic and plaque formation
IL and TNFa= amplify inflammatory cascade and stimulate keratinocyte proliferation
High serum VEGF caused angiogenesis
Cell cycle is reduced from 28 to 3-5 days

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8
Q

What is the histology of psoriasis?

A
Hyperkeratosis
Neutrophils in stratum corneum
Psoriasform hyperplasia
Dilated dermal capillaries
T cel infiltration
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9
Q

What i hyperkeratosis seen as histologically?

A

Thickening of stratum corneum

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10
Q

What is psoriasform hyperplasia seen as histologic;ly?

A

Thickening of squamous cell layer

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11
Q

What history should be taken for psoriasis?

A
Age and nature of onset
Distrubution
Effective treatments
Medical history
Family history
Medications
Quality of life
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12
Q

What are the signs and symptoms of psoriasis?

A
Sharply demarcated, erythematous plaques
Numerous small, widely disseminated papule ad plaques
Erythroderma
Nail pitting and oil spots, onycholysis
Koebner phenomenon
Woronoff's ring
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13
Q

What is Koebner phenomenon?

A

Lesions along area of injury

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14
Q

What is Woronoff’s ring?

A

Blanched halo around lesions after phototherapy

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15
Q

What are the types of psoriasis?

A
Chronic plaque psoriasis
Guttate psoriasis
Palmo-plantar psoriasis
Scalp psoriasis
Nail psoriasis
Plexural/inverse psoriasis
Pustular psoriasis
Erythrodermic psoriasis
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16
Q

What is the appearance oc chronic plaque psoriasis?

A

Large salmon coloured plaques with thick scale

Symetric, extensor surfaces

17
Q

What is the trigger of guttate psoriasis?

A

Viral or bacterial infection

18
Q

Who is guttate psoriasis seen in?

A

Children and adolescents

19
Q

Wha is the appearance of guttate psoriasis?

A

Multiple pink papule with fine scale

20
Q

What are the possible outcomes of guttate psoriasis?

A

REsolve

Trigger chronic psoriasis

21
Q

What is palm-plantar psoriasis associated with?

22
Q

What is the appearance of palmo-plantar psoriasis?

A

Thick, scaly and red with yellow/brown lesions at the edges

23
Q

What is the appearance of scalp psoriasis?

A

Alopecia at affected areas
Pink hyperkeratotic plaques
Severe dandruff

24
Q

What is the appearance of nail psoriasis?

A

Pitting or oil spots on nails

25
What is the issue with nail psoriasis?
Difficult to treat
26
What is the appearance of flexural psoriasis?
Skin pink or red sharply demarcated plaques | Less scaly
27
What triggers flexural psoriasis?
Localised dermaphyte, candida or bacterial infection
28
What is th appearance of pustular psoriasis?
Sterile pustules and generalised red tender patches | Sometimes systemic symptoms
29
What are the triggers of pustular psoriasis?
Pregnancy Rapid tapering or stopping steroids Hypoglycaemia Infection
30
What is the appearance of erythrodermic psoriasis?
Red man syndrome >80% body surface involved- erythematous with fine scale Hypotensive and pyrexial
31
What is the differential diagnosis for psoriasis?
Seborrhoeic dermatitis Lichen planus Mycosis fungoides
32
What is the treatment of psoriasis in primary care?
``` Emollients Soap substitutes Vit D analogues Coal tar creams Topica steroid Salicylic acid ```
33
What is the treatment of psoriasis in dermatology?
Crude coal tar Dithranol UVB phototherapy
34
What is the systemic treatment of psoriasis?
Retinoid Immunosuppression Biologics
35
What immunosuppressants are used in psoriasis?
Methotrexate | Ciclosporin
36
What is the treatment of erythrodermic psoriasis?
``` Admit FLuid balance Bloods Thick greasy ointment/emollient Systemic treatment ```