Psoriasis

Question 1

what is psoriasis?

Answer 1

a chronic condition due to hyperproliferation of keratinocytes and inflammatory cell infiltrates

Question 2

what are signs of psoriasis?

Answer 2

well demarcated scaly plaques that can be found on extensors. itchy.

nail pitting and onchylysis

arhtritis

Question 3

what is the management?

Answer 3

1. avoid worsening factors
2. emollients can reduce scales
3. localised/mild: topical vit d analogues/ topical steroids/ coal tar, dithranol, topical retinoids
4. extensive disease; phototherapy
5. severe or systemic: methotrexate/retinoids/ciclosporin

Question 4

what nail changes occur in psoriasis?

Answer 4

onycholysis
pitting
ridging

Question 5

what causes psoriasis?

Answer 5

multifactoral
genetic: PSORS1 MHC on chromosone 6
exacerbating factors: trauma, infection, sunlight,drugs

Question 6

what is generalised pustular psoriasis?

Answer 6

a dermatology emergency

Question 7

what are triggers for generalised pustular psoriasis?

Answer 7

skin infection
rapid withdrawal of systemic steroids
lithium
beta blockers

Question 8

what are features of generalised pustular psoriasis?

Answer 8

erythema
painful
oedema
superficial pustules
desquamation
aki

Question 9

what is the Mx of generalised pustular psoriasis?

Answer 9

ICU
topical emollient
systemic IV infliximab or ciclosporin