Psoriasis Flashcards
What is Psoriasis?
Chronic inflammatory skin disease characterised by erythematous, circumscribed scaly papules, and plaques.
How many people are affected by Psoriasis?
3% of UK population M=F
Peak incidence in 20s and 50s
Causes of Psoriasis
Genetics Overactivity of the immune system - epidermal infiltration by activated T cells. Excessive production of TH1 Cytokines Environment Infection - Strep, Candida Drugs - NSAIDs
What does it look like?
Red scaly plaques Often symmetrical distribution Chronic plaque Flexural Acute Guttate Scalp Palmoplantar Nail Pustular Erythrodermic
Sub types of Psoriasis:
Chronic Plaque Psoriasis
management
Accounts for 90% of cases
Commonly managed with topical treatments.
Guttate psoriasis:
When does it occur? Describe it.
Post viral
Self-limiting
Responds well to phototherapy
Palmo-plantar psoriasis:
What is it?
Palms and soles - tend to have greater impact on patients quality of life.
Scalp and nail psoriasis
Scalp - Seborhoeic dermatitis
Nail - Pathogonomic feactures - pitting and onycholysis.
Flexural / Inverse Psoriasis
Lack of scale
Pustular Psoriasis
Grouping of small white pustules
Erythrodermic psoriasis
“red man” syndrome
> 90% body surface area involved
needs in-patient treatment
Initial treatment for Psoriasis
- Emollients - Creams vs ointments
- Vit D3 analogues (plus or minus top steroids) - inhibits epidermal proliferation
- Tar creams
- Topical steroids - flexural / genital area
- Salicylic acid
- Dithranol
- Anthralin
If initial treatment fails what is next?
UVB phototherapy Acitretin Methotrexate Cyclosporin Biologics
Treatment for Erythrodermic Psoriasis
Admit
Fluid balance
Bloods / IV access
Thick greasy ointments emollients
What are the associations?
CV disease, smoking, alcohol, metabolic syndrome, depression, lymphoma, suicide, melanoma
