Psoriasis Flashcards
What are the ages of the peak incidences of psoriasis?
20s and 50s
Is psoriasis more common in males or females?
Males -=females
What is the aetiology of psoriasis?
polygenic redistribution + environmental triggers
genetics infection drugs trauma sunlight
What are the systemic diseases associated with psoriasis?
Psoriatic arthritis
Physio social complications
Metabolic syndrome
what drugs can cause psoriasis?
NSAIDS
lithium
beta blockers
steroid withdrawal
what is the pathogenesis of psoriasis?
overactivity of the immune system
excessive production of Th1 cytokines including TNF alpha
increased epidermal cell proliferation and turnover
capillary angiogenesis
describe some of the features in the histology of psoriasis.
hyperkeratosis (thickening of stratum coreneum)
parakeratosis (keratinocytes with nuclei in stratum corneum)
neutrophils in stratum corneum
hypogranulosis
psorasiform hyperplasia: acanthuses (with elongated retentions ridges)
T cell infiltration
dilated dermal capillaries
what does psoriasis plaques look like?
red and scaly
well defined edges
often symmetrical distribution
what are the different subtypes of psoriasis?
chronic plaque flexural / inverse psoriasis scalp nails guttate palmo-plantar/ pustulosis erythrodermic psoriasis
what can trigger guttate psoriasis and what age is it commonly found?
viral or bacterial infection
children/adolescence
what treatment does guttate psoriasis respond well to?
phototherapy
what is a differential diagnosis of scalp psoriasis and how would you differentiate the two?
seborrhoeic dermatitis
scalp psoriasis extends below the hairline
what 2 features are found in nail psoriasis?
pitting onycholysis
what can trigger flexural / inverse psoriasis?
localised dermatophyte (fungal)
candida
bacterial infection
what is erythrodermic psoriasis?
red man syndrome
> 80% of body is involved
what are differential diagnoses of psoriasis?
seborrhoeic dermatitis
lichen plants
mycosis fungicides
bowens disease
what is the initial treatments for psoriasis?
emollients vitamin D3 analogue tar creams topical steroids salicylic acid
what are the 2nd line treatments for psoriasis?
UVB phototherapy
retinoids i.e. Acitretin
methotrexate
cyclosporin biologics i.e. infliximab, adalimuab
what is the teatment for erythrodermic psoriasis?
fluid balance
blood / IV access
thick greasy ointment emollients
how do you monitor progress of psoriasis ?
PASI -Psoriasis area severity index
dermatology life quality index (DLQI)
what complications is psoriasis associated with?
CV disease arthritis metabolic syndrome depression possibly melanoma and non melanoma skin cancers
