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Dermatology RIA > Psoriasis > Flashcards

Psoriasis Flashcards

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Dermatology Board Prep flashcards
1
Q

aetiology

A

family hx present in 40-50% cases

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2
Q

pathophysiology

A
  • epidermal hyperplasia
  • T cell infiltration: CD4 + CD8
  • inflam cascade involving TNF alpha
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3
Q

features of psoriatic nails

A
  • periungal erythema
  • pitting
  • subungal hyperkeratosis
  • onycholysis
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4
Q

triggers (7)

A
  • smoking
  • alcohol
  • stress
  • infection
  • trauma
  • drugs
  • post partum pregnancy
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5
Q

which drugs can trigger psoriasis

A
  • some anti malarials
  • lithium
  • beta blockers
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6
Q

description of psoriatic lesions

A
  • pink/red
  • silvery/scale appearance
  • well defined edges
  • symmetrical
  • extensor surfaces
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7
Q

appearance of guttate psoriasis

A

multiple small tear drop pink lesions affecting large area of body

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8
Q

cause of guttate psoriasis

A

comes on quickly following streptococcal sore throat

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9
Q

name a trigger for erythrodermis psoriasis

A

withdrawal of systemic steroids

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10
Q

presentation of erythrodermis psoriasis

A

skin: hot, red, painful
unwell + hypotensive
no longer have clear defined plaques

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11
Q

flare up of psoriasis that becomes red, hot, painful + development of pustules within plaques?

+ whats a trigger?

A

Generalised pustular psoriasis

Trigger = withdrawal of inappropriate superpotent steroid use

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12
Q

having psoriasis increases your risk of ?

A
  • MI
  • T2DM
  • hyperlipidaemia
  • metabolic syndrome
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13
Q

Psoriatic arthritis affects … (joints)

A
  • DIPs

- spares MCPs

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14
Q

more likely for psoriatic arthritis to occur before or after psoriasis of skin

A

before

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15
Q

validated screening tool for psoriatic arthritis?

A

PEST = psoriatic epidemiology screening tool

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16
Q

75% patients have a genetic link with…

A

HLA-CW6

Psons 1 gene

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17
Q

indexes to assess severity of disease

A

1) PASI - psoriasis area severity index

2) DLQI - dermatology life quality index

18
Q

treatment to reduce pruritus + scale loss

A

regular emollients

19
Q

topical treatments

A

application of a potent corticosteroid OD
+
Vitamin D analogue applied OD

for up to 4 weeks as initial treatment

20
Q

2nd line topical treatment if no improvement with topical corticosteroid for 8 weeks…

A

Vitamin D analogue BD

21
Q

3rd line topic trx

A

potent corticosteroid applied BD for up to 4 weeks
OR
coal tar preparation BD

22
Q

examples of Vitamin D analogues + their benefits

A
  • Calcitriol
  • Calcipotriol

Reduce cell division + differentiation –> reduce scale + thickness of plaques (but not erythema

23
Q

name 4 secondary care treatments

A
  • phototherapy
  • ciclosporin
  • methotrexate
  • acitretin
24
Q

2 types of phototherapy

A

1) Narrow band UVB

2) PUVA = Psoralen + UVA (photochemotherapy)

25
Q

adverse effects of phototherapy

A
  • skin ageing

- squamous cell carcinoma

26
Q

1st line choice for systemic therapy

A

methotrexate

27
Q

when to offer systemic non biological therapies? (such as ciclosporin + methotrexate)

A
  • cannot be controlled with topical therapy
  • sig impact on physical, psychological, social welbeing
  • extensive psoriasis (>10% body SA)
  • phototherapy has been in effective
28
Q

e.g. of systemic biological therapy and mechanism

A
  • adalimumab
  • etanercept
  • infliximab

TNF blockers

29
Q

describe the psoriatic patches:

A

dry, flaky, scaly & erythematous

raised & rough

30
Q

location of psoriatic plaques

A

extensor surfaces e.g. of knees and elbows

31
Q

which type of psoriaiss is more common in children

A

guttate

32
Q

what is guttate psoriasis triggered by

A

strep throat

33
Q

widespread smal pink plaques - what psoriasis

A

guttate

34
Q

skin comes away in large patches - exposing raw areas, skin feels hot

what psorisais?

A

erythrodermic

35
Q

what is auspitz sign

A

small points of bleeding when plaques are scraped off

36
Q

koebrer phenomena

A

development of psoriatic lesions to areas of skin affected by trauma

37
Q

how does Narrow b & UVB or PUVA help psoriasis

A

by slowing down keritonocyte proliferation

38
Q

initial treatment for psoriasis & duration

A

potent corticosteroids OD & Vit D analogue OD for up to 4 weeks

39
Q

2nd and 3rd line for psoriasis

A

2nd: increase Vit D analogue to BD

3rd line: potent corticosteroid BD for 4 weeks or coal tar preparation BD

40
Q

example of 2 vit D analogues

A

Calcitriol & calcipotriol

41
Q

mechanism of vit D analogs

A

reduce cell division & differentiation to reduce scale & thickness of plaques

42
Q

1st line choice of systemic treatment for psoriasis

A

methotrexate

Dermatology RIA (7 decks)

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