Psoriasis Flashcards
5 classifications of psoriasis
based on morphology: plaque inverse/flexural guttate erythrodermic pustular
guttate pres
acute onset of raindrop size lesions on trunk and extremities, often preceded by strep pharyngitis
good chance for long term remission
inverse psoriasis pres
erythematous plaques in axilla, groin, other skin folds
may lack scale, from moisture
pustular psoriasis pres, trigger
psoriatic lesions w/ pustules
often triggered by CS withdrawal
can be life threatening when generalized
palmoplantar psoriasis
can be either plaque or pustular on feet and palms
often misdiagnosed as tinea pedis
erythrodermic psoriasis pres
involved almost all the skin, bright red
assoc w/ fever chills and malaise, sometimes requires hospitalization
erythroderma complications
high output HF, sepsis
plaque psoriasis pres
well demarcated plaques, overlying scale and underlying erythema
typically symmetric and bilateral
two signs possible w/ plaque psoriasis
auspitz sign- bleeding after scale removal
koebner sign- lesions are induced by trauma
most common psoriasis
plaque, 20% have moderate to severe disease
pathogenesis of psoriasis
cytokines trigger hyperproliferative state, causes thick skin and excessive scale
can be triggered by trauma
key areas for psoriasis
scalp, ears, elbows, knees (extensor), umbilicus, gluteal cleft, nails
psoriatic onychodystrophy pres- 3 possible findings
pitting- punctate depressions
onycholysis- separation of nail plate from nail bed
subungal hyperkeratosis- abnormal keratinization of distal nail bed
higher risk of psoriatic arthritis
psoriatic arthristis is an examples of
seronegative spondyloarthropathies
pres of PsA
usually relapsing oligoarthritis, with distal interphalangeal joints
10-15% of pts w/ psoriasis, need tx
desquamation of overlying skin and joint swelling/deformity
