Psoriasis Flashcards
What % of the population have psoriasis
2%
What are the 2 ages groups that get psoriasis?
Late teens
50s
Aetiology psoriasis (3)
FHx
Enviro
HLA-CW6
What is the most common type of psoriasis
Chronic plaque psoriasis
Features chronic plaque psoriasis (7)
Salmon pink patches /plaques Well demarcated Silver scale Extensors Symmetrical Nail changes
Nail changes seen in psoriasis (3)
Pitting
Onycholysis
Subungal hyperkeratosis
DDx flexural psoriasis (3)
Eczema
Heat rash
Fungal infection
Areas affected by flexural psoriasis (5)
Armpits Penis Umbilicus Under breasts Natal cleft
Who gets guttate psoriasis
Children/adolescents
Cause guttate psoriasis
Acute strep infection
Appearance guttate psoriasis
Rain drop lesions
In linear configuration
What may guttate psoriasis precede?
Chronic plaque psoriasis
What % body SA is affected in erythrodermic psoriasis?
> 90%
Who gets palmoplantar pustular psoriasis
F
ADults
who are smokers
What precipitates generalised pustular psoriasis
Steroid withdrawal
Appearance generalised pustular psoriasis
sheets pustules
+ background erythema
What is the Koebner phenomenon
Tendency for a skin condition to occur within scars or sites of trauma
What area of the body is hardest to get rid of psoriasis from?
Legs
Aggravating factors psoriasis (7)
Strep Medication Stress Alcohol Cigarettes Trauma Friction
What medications can aggravate psoriasis?
Beta blockers
Lithium
Anti-malarials
At what DLQI score would you consider psychological intervention?
> 10
What score determines the serverity of psoriasis?
PASI
How is the PASI score calculated?
Redness
Thickness
Scaling
A PASI score of what would indicate systemic treatment should be commenced?
> 10
1st line Tx psoriasis
Emollients e.g. E45 Calcipotriol TO CCS e.g. eumovate Keratoyltics - salicylic acid Coal tar Dithranol
1st line Tx thick plaques
Salicylic acid
Dithranol
1st line Tx guttate psoriasis (4)
Emollients
Coal tar
Clcipotriol dovonex
TL01 UVB
Specific Tx - scalp psoriasis
Cocois
Coal tar shampoo
TO CCS scalp application
Specific Tx - face psoriasis
Mild TO CCS - 1% HC
Specific Tx - flexural psoriasis
Calcitriol ointment
SE - phototherapy (3)
Erythema/pruritis
Nausea
Skin cancer
Mx Eryhthrodermic psoriasis, generalised pustular psoriasis
Admit
Supportive
Liberal emollients/potent TO steroids
3rd line Tx psoriasis (3)
Methotrexate
Ciclosporin
Acitretin
Methotrexate SE
Teratogenicity Nausea GI upset Liver fibrosis Marrow suppression
What MUST be monitored inf on methotrexate
LFT
FBC
SE ciclosporin
HTN Nephrotoxicity Carcinogenesis Gym hypertrophy Tingling peripheries
What must be monitored if on ciclosporin
BP
U+E
How long is acitretin teratogenic for?
2 years
SE acitretin (4)
Dry skin
Dry lips
Hyperlipidaemia
Hepatotoxicity
What must be monitored if on acitretin
Fasting lipids
LFTs
