Psoriasis Flashcards

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1
Q

Appearance of psoriasis

A

sharply demarcated erythematous plaque with micaceous scale

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2
Q

How is psoriasis a systemic disease?

A

psoriatic arthritis
psychosocial
metabolic syndrome - CVS

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3
Q

Cause of psoriasis

A

polygenic - HLA

environmental triggers

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4
Q

Environmental triggers for psoriasis

A

infections
drugs
trauma
sunlight

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5
Q

How are dermal dendritic cells activated?

A

interleukins, TNF alpha

stressed keratinocytes

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6
Q

Pathogenesis of psoriasis

A

DDC present to naïve T cells

Th cells –> plaque formation

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7
Q

What happens to the cell cycle in psoriasis?

A

decreased from 28 days to 3-5 days

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8
Q

When are neutrophils found in psoriasis?

A

active, pustular disease

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9
Q

Histology of psoriasis

A

hyperkeratosis
neutrophils in corneum
dilated capillaries
T cell infiltration

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10
Q

Things to ask in history

A
Age and nature of onset 
distribution 
medication history 
family history 
effective treatments 
QOL
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11
Q

Skin examination

A
distribution - symmetrical, extensor 
sharply demarcated plaques
erythematous 
papulosquamous
papules and pustules
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12
Q

Nails examination

A

onycholosis
pitting
oil spots

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13
Q

Name 8 types of psoriasis

A
erythematous 
palmo-plantar
chronic plaque 
guttate
scalp
nail 
flexural/inverse 
pustular
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14
Q

Guttate psoriasis - who is effected and triggers

A

children, young

viral/bacterial infection

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15
Q

Differential diagnoses for inverse psoriasis

A

dermatophye, candida or bacterial infection

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16
Q

Causes of pustular psoriasis

A

pregnancy, rapid stop steroids, hypocalcaemia, infection

17
Q

2 possible ways to diagnose psoriasis

A

clinical findings

biopsy if atypical

18
Q

3 differential diagnoses for psoriasis

A

seborrheic dermatitis
lichen planus
mycosis fungoides

19
Q

What is mycosis fungoides?

A

cutaneous lymphoma

20
Q

Treatment of psoriasis in GP

A
coal tar cream 
emollient 
soap substitute 
vitamin D3 analogues
salicylic acid 
topical steroids
21
Q

Treating psoriasis in secondary care

A
Crude coal tar 
dithranol 
UVB phototherapy 
retinoid 
immunosuppression 
biologic therapy
22
Q

Future therapies for psoriasis

A

targeted biologics
IL -17,20,22
kinase inhibitors

23
Q

Treatment of erythodermic psoriasis

A
IV/blood access 
emollient 
recognise 
admit 
fluid balance 
systemic or biologic treatment 
thick greasy emollient
24
Q

2 index to monitor progress

A

psoriasis area severity

dermatology life quality

25
Q

Psoriasis area severity index factors

A

surface area
plaque colour
thickness
scale

26
Q

Dermatology life quality index factors

A

QOL in last week

27
Q

psoriasis prognosis

A

3/4 year life reduction

linked to CVD, skin cancer, depression, suicide, smoking, alcohol