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Dermatology AM > Psoriasis > Flashcards

Psoriasis Flashcards

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Dermatology Board Prep flashcards
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?

A

SMoking

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
Q

What is the issue with nail psoriasis?

A

Difficult to treat

26
Q

What is the appearance of flexural psoriasis?

A

Skin pink or red sharply demarcated plaques

Less scaly

27
Q

What triggers flexural psoriasis?

A

Localised dermaphyte, candida or bacterial infection

28
Q

What is th appearance of pustular psoriasis?

A

Sterile pustules and generalised red tender patches

Sometimes systemic symptoms

29
Q

What are the triggers of pustular psoriasis?

A

Pregnancy
Rapid tapering or stopping steroids
Hypoglycaemia
Infection

30
Q

What is the appearance of erythrodermic psoriasis?

A

Red man syndrome
>80% body surface involved- erythematous with fine scale
Hypotensive and pyrexial

31
Q

What is the differential diagnosis for psoriasis?

A

Seborrhoeic dermatitis
Lichen planus
Mycosis fungoides

32
Q

What is the treatment of psoriasis in primary care?

A 
Emollients
Soap substitutes
Vit D analogues
Coal tar creams
Topica steroid
Salicylic acid
33
Q

What is the treatment of psoriasis in dermatology?

A

Crude coal tar
Dithranol
UVB phototherapy

34
Q

What is the systemic treatment of psoriasis?

A

Retinoid
Immunosuppression
Biologics

35
Q

What immunosuppressants are used in psoriasis?

A

Methotrexate

Ciclosporin

36
Q

What is the treatment of erythrodermic psoriasis?

A 
Admit
FLuid balance
Bloods
Thick greasy ointment/emollient
Systemic treatment

Dermatology AM (9 decks)

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