Psoriasis Flashcards
what is it?
- Chronic auto immune disorder
- Accumulation of excess skin (hyperproliferation)
- Unregulated epidermal growth and differentiation
- incomplete keratinisation of stratum corneum (thicken)
- stratum corneum becomes ‘loose’ and unattached
1.Chronic plaque/Vulgaris 2.Guattate 3.Inverse (Flexural) 4.Pustular 5Erthrodermic
1.-most common, symmetrical
-plaques are 1-10cm
2.Guattate
3In the body folds (obese)
4.rare, white puss looking things
(not infectious)
5.red and peeling
coal tar
MOA
1.Anti-angiogenic activity Anti-inflammatory and antipruritic (Stops the growth of blood vessels) 2.↓ IL15 3.↓ Inducible Nitric Oxide Synthase
Dithranol
MOA
Unknown
-possible DNA synthesis inhibition
Calcipotriol
davionex
Vitamin D3 analogue -it binds to D3 receptors in skin -Causing immunomodulatory response -↓ keratinocytes and differentiation -↓ IL-2, IL-6 (similar to topical steoids)
Acitretin
MOA
Reverses the epidermal proliferation and increased keratinisation seen in hyperkeratotic disorders.- AMH
Cyclosporin A
(neoral)
MOA
alcineurin inhibitors
1.Binds to Cyclophilin creating a complex that binds to calcineurin ↓ function
Immunophillins ONLY found in immune cells
They contain cyclophillins and KF506 -responsible for ‘folding’ proteins
-therefore, they are SELECTIVE
Severe psoriasis when other treatments have failed
Tacrolimus
MOA
Calcineurin inhibitors
- Binds to KF506, thus creates a complex that binds to calcineurin ↓ function
- ↓mast cells and release of mediators
- ↓IL-8
Hydroxyurea
hydrea
INhibits DNA
used for sickle cell and leukeamia
phototherapy
PUVA (320-400)
give with methozsalen 2 hrs before)
PASI
Psorisis Area and severity index
(0-72)
>10 = severe
DQLI
Dermatology life and quality index
