Psoriasis Flashcards

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1
Q

psoriasis is a chronic multisystem disease with predominantly _____ and _____ manifestations

A
  • skin and joint
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2
Q

age of onset of psoriasis

A
  • 20-30s - 50-60
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3
Q

____% of patients with a family history have psoriasis

A
  • 33% - strong genetic component
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4
Q

does psoriasis just go away after treatment or does it wax and wane over time?

A
  • waxes and wanes
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5
Q

what form of psoriasis are scaly, erythematous patches, papules, and plaques that are sometimes pruritic

A
  • plaque
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6
Q

what form of psoriasis are lesions located in the skin folds of the axilla, groin, inframammary region do they have scale? why?

A
  • inverse/flexural - no; due to moistness of area
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7
Q

what form of psoriasis presents with raindrop lesions, 1-10 mm salmon-pink papules with a fine scale

A
  • gluttate
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8
Q

what form of psoriasis are generalized erythema covering nearly the entire body surface area with varying degrees of scaling

A
  • erythrodermic
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9
Q

what form of psoriasis are generalized or palmoplantar

A
  • pustular
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10
Q

what form of psoriasis is the acute onset of raindrop sized lesions on the trunk and extremities

A
  • gluttate psoriasis
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11
Q

gluttate psoriasis often preceded by

A
  • streptococcal pharyngitis
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12
Q

gluttate psoriasis chance for long term remission after single episode

A
  • significant chance
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13
Q

what type of psoriasis is characterized by corticosteroid withdrawal

A
  • pustular
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14
Q

when generalized, pustular psoriasis can be _______

A
  • life threatening
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15
Q

what type of psoriasis is often misdiagnosed as athlete’s foot

A
  • palmoplantar psoriasis
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16
Q

what type of psoriasis involves almost the entire skin surface where the skin is bright red

A
  • psoriatic erythroderma
17
Q

by definition, erythema in erythroderma affects what percent body surface area

A

> 90%

18
Q

what type of psoriasis often requires hospital admission to manage complications such as high output heart failure and sepsis

A
  • psoriatic erythroderma
19
Q

how to distinguish the cause of psoriatic erythroderma

A
  • biopsy
20
Q

treatment of psoriatic erythroderma

A
  • topical therapy - monitor fluids/electrolytes - treat underlying cause
21
Q

what is auspitz sign

A
  • bleeding after removal of scale
22
Q

what is koebner phenomenon

A
  • lesions induced by trauma
23
Q

what is the most common form of psoriasis

A
  • plaque psoriasis
24
Q

what is the pathogenesis of psoriasis

A
  • cytokines trigger hyper proliferative state resulting in thick skin and excess scale
25
Q

how can trauma (ie Koebner phenomenon) trigger or fuel psoriasis

A
  • increases cytokines
26
Q

psoriasis can be more severe in patients with _____

A
  • HIV
27
Q

key areas for psoriasis

A
  • scalp - ears - extensor surfaces - umbilicus - gluteal cleft - nails - sites of recent trauma
28
Q

what does psoriatic onychodystrophy indicate

A
  • nail psoriasis - higer risk of psoriatic arthritis
29
Q

what you see in psoriatic onychodystrophy

A
  • pitting - depressions of nail plate surface - onycholyisis - separation of the nail plate from the nail bed - subungual hyperkeratosis - abnormal keratinization of the distal nail bed
30
Q

most common joints in psoriatic arthritis

A
  • distal interphalangeal joints
31
Q

what treatment of psoriasis is indicated if it is localized

first line agents

A
  • topical treatment - high potency topical steroid +/- calcipotriene
32
Q

topical medications for psoriasis are more effective when used with _____ with allows for better penetration

A
  • occlusion
33
Q

what treatment is used in addition to topical treatment for moderate-severe disease or for limited disease with high impact on quality of life

A
  • systemic treatment
34
Q

should oral steroids be used in psoriasis why

A
  • no - can severely flare psoriasis upon discontinuation
35
Q

3 choices for systemic treatment

A
  • phototherapy - oral medications - biologic agents
36
Q

phototherapy for systemic treatment of psoriasis

A
  • narrow band UVB light - psoralen plus UVA light
37
Q

oral medications systemic treatment of psoriasis

A
  • methotrexate - acitretin - cyclosporine
38
Q

biologic agents for systemic treatment of psoriasis

A
  • TNF-alpha inhibitors - IL 12/23 blocker
39
Q

up to 90% of patients with psoriatic arthritis may have ____ changes

A
  • nail changes