Psoriasis Flashcards

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1
Q

Outline the pathogenesis of chronic plaque psoriasis

A

Hyperproliferation of epidermal cells giving ride to scale
Increase cells entering cell cycle from basal layer
Faster turnover
Accumulation of inflammatory cells

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2
Q

Give examples of precipitating factors for psoriasis

A
Emotional stress
Infection
Drugs
Alcohol
Trauma
Smoking
Radiation
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3
Q

Which drugs are heavily implicated in precipitating psoriasis?

A

Lithium
Beta blockers
Steroid withdrawal
Anti-malarials

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4
Q

What are the histological features of psoriasis?

A

Thickened parakeratotic cells in stratum corneum
Micro abscesses in SC
Absence of granular layer
Expanded spinous layer

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5
Q

What is the most common form of psoriasis?

A

Chronic plaque

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6
Q

How does chronic plaque psoriasis present?

A

Erythematous, scaly, raised plaques
Extensor surfaces
Auspitz sign
Koebner phenomenon

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7
Q

What is Ausptiz sign?

A

Removing a piece of scale from the plaque results in pin point pleeding

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8
Q

What is the Koebner phenomenon?

A

Areas of psoriasis occurring following trauma

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9
Q

How does scalp psoriasis present?

A

Like chronic plaque psoriasis but on the scalp

Very itchy

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10
Q

How is scalp psoriasis managed?

A

Olive oil
Tar shampoo
Salicylic acid

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11
Q

What is the classic presentation of Guttate psoriasis?

A

Onset of “red raindrop rash” in young patients following infection

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12
Q

How does flexural psoriasis present?

A

Shiny, red, well demarcated lesions
On going, axillae, inframammary areas
Not scaly as areas are moist

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13
Q

How is flexural psoriasis treated?

A

Mild steroid and antifungal

as hard to distinguish from fungal infection

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14
Q

What is palmoplantar psoriasis?

A

U guess it

Psoriasis on the palms and soles - very sore

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15
Q

What is palmoplantar pustulosis?

A

Again u guessed it
Pustules on the palms and soles
Sterile and fade to brown macules over a few days

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16
Q

Palmoplantar pustulosis is strongly associated with alcohol T/F

A

False

Associated strongly with smoking

17
Q

Which sex is palmoplantar pustulosis more common in?

A

Females

18
Q

What is erythodermic psoriasis?

A

When over 90% of the skin surface is red

19
Q

How is erythrodermic psoriasis treated?

A

Fluid balance correction
Bed rest
Emollients
Systemic immunosuppression

20
Q

What is the main concern in generalised pustular psoriasis?

A

Development of an infection

21
Q

How does coal tar work to treat psoriasis?

A

Reduces DNA synthesis and epidermal proliferation

22
Q

How does dithranol work to treat psoriasis?

A

Reduces epidermal proliferation via anti-mitotic mechanism

23
Q

What is the main problems with coal tar?

A

Brown and smells

24
Q

What is the main problem with dithranol?

A

Burns normal skin

Can stain

25
Q

Outline the phototherapy process for psoriasis

A

UVB used 3x/week for 6-8 weeks

26
Q

What is photochemotherapy?

A

Psoralens plus UVA

27
Q

Why are psoralens given to patients for photochemotherapy?

A

Plant extracts which sensitise the skin