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Dermatology > Psoriasis > Flashcards

Psoriasis Flashcards

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Dermatology Board Prep flashcards
1
Q

Which gene is most commonly related to psoriasis?

A

PSORS 1 location on chromosome 9 (6p21.3)

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2
Q

Which HLA antigen gives a person a 10 fold increase of developing psoriasis?

A

HLA-Cw6

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3
Q

What is the pathogenesis of psoriasis?

A

Hyperproliferation of epidermal cells
T lymphocytes move out of the blood vessels in the skin and into the dermis
Higher levels of calcium-binding protein found in psoriatic plaques

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4
Q

Name some precipitating factors of psoriasis?

A
  1. Emotional stres
  2. Infection - strep throat causing guttate psoriasis
  3. Drug - Beta-Blockers, lithium, antimalarials, withdrawal of topical or systemic steroids
  4. Alcohol
  5. Trauma - Koebner phenomenon
  6. Smoking
  7. HIV/AIDS
    (8. UV irradiation - 10% worsen)
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5
Q

What are the histological features of psoriasis?

A
  1. Parakeratotic stratum corneum (contains nuclei – normally none)
  2. Absence of granular layer
  3. Expanded prickle cell layer
  4. Large capillary vessels in papillary dermis
  5. Leucocytes – Munro microabscesses in stratum corneum
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6
Q

What are the psoriasis sub-types?

A
  1. Chronic plaque
  2. Guttate
  3. Scalp
  4. Flexural
  5. Palmoplantar psoriasis
  6. Palmo plantar pustulosis
  7. Erythrodermic
  8. Pustular - generalised
  9. Nail
  10. Psoriatic arthritis
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7
Q

Which areas are most commonly affected by chronic plaque psoriasis?

A

Extensor aspects of knees, elbows, sacrum and scalp. Often symmetrical

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8
Q

What is Auspitz’ sign?

A

Removing scale reveals pin-point bleeding - positive in chronic plaque psoriasis

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9
Q

What is Koebner phenomenon?

A

Skin lesions which appear at the site of trauma 2-6 weeks after trauma sustained

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10
Q

What is the typical age of someone who develops guttate psoriasis?

A

15-25 years old

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11
Q

Guttate psoriasis is classically triggered by what?

A

Streptococcal sore throat - develop multiple small psoriatic lesions on trunk 7-10 days later

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12
Q

What is the treatment for guttate psoriasis?

A

Emollients
Topical tar
Phototherapy

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13
Q

What is the treatment for scalp psoriasis?

A

Olive oil
Tar shampoos e.g. Polytar(R)
Coconut oil e.g. Cocois(R)

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14
Q

Where on the body is flexural psoriasis typically found?

A

Groin, axillae or inframammary

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15
Q

Describe flexural psoriasis?

A

Shiny, red, well-demarcated plaques

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16
Q

What is the treatment for flexural psoriasis?

A

Mild topical steroid / antifungal preparations (e.g. Trimovate® cream, Canesten HC® cream)

17
Q

What is the treatment for palmoplantar psoriasis?

A 
Topical tar preparations
Salicylic acid
Topical steroids
Phototherapy
Systemic immunosuppressants
(Palmolantar psoriasis is difficult to treat)
18
Q

Palmoplantar pustulosis is stronger associated with what cause?

A

Smoking

19
Q

Describe palmoplantar pustulosos?

A

Sterile yellow pustules fading to brown macules

20
Q

What is erythrodermic psoriasis?

A

Erythroderma covering >90% of the skin in a patient wit psoriasis

21
Q

What are some of the causes of erythrodermic psoriasis?

A

Withdrawal of potent topical or systemic steroids
Drug reactions
Ultraviolet burns etc

22
Q

What are the complications of erythrodermic psoriasis?

A 
Hypothermia
Cardiogenic shock
Dehydration
Anaemia
Hypoproteinaemia
23
Q

What is the treatment for erythrodermic psoriasis?

A

Fluid balance
Bed rest
Emollients
Systemic immunosuppressants

24
Q

Describe pustular psoriasis?

A

Generalised, painful skin, fever, malaise, sterile pustules

25
Q

What are some of the causes of pustular psoriasis?

A

Withdrawal of steroids, infection, pregnancy, hypocalcaemia

26
Q

What is the treatment for pustular psoriasis?

A

Bed rest, emollients, monitor for infection, fluid balance, monitor protein, systemic immunosuppressants

27
Q

What are the 5 main patterns of psoriatic arthritis?

A
  1. Asymmetric oligoarthritis (60-70%)
  2. Symmetrical polyarthritis (15%)
  3. Distal phalangeal joint disease (5%)
  4. Destructive arthritis (arthritis mutilans – 5%)
  5. Axial arthritis (5%) (spondylitis/sacroiliitis)

Dermatology (16 decks)

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