Psoriasis Flashcards
Outline the pathogenesis of chronic plaque psoriasis
Hyperproliferation of epidermal cells giving ride to scale
Increase cells entering cell cycle from basal layer
Faster turnover
Accumulation of inflammatory cells
Give examples of precipitating factors for psoriasis
Emotional stress Infection Drugs Alcohol Trauma Smoking Radiation
Which drugs are heavily implicated in precipitating psoriasis?
Lithium
Beta blockers
Steroid withdrawal
Anti-malarials
What are the histological features of psoriasis?
Thickened parakeratotic cells in stratum corneum
Micro abscesses in SC
Absence of granular layer
Expanded spinous layer
What is the most common form of psoriasis?
Chronic plaque
How does chronic plaque psoriasis present?
Erythematous, scaly, raised plaques
Extensor surfaces
Auspitz sign
Koebner phenomenon
What is Ausptiz sign?
Removing a piece of scale from the plaque results in pin point pleeding
What is the Koebner phenomenon?
Areas of psoriasis occurring following trauma
How does scalp psoriasis present?
Like chronic plaque psoriasis but on the scalp
Very itchy
How is scalp psoriasis managed?
Olive oil
Tar shampoo
Salicylic acid
What is the classic presentation of Guttate psoriasis?
Onset of “red raindrop rash” in young patients following infection
How does flexural psoriasis present?
Shiny, red, well demarcated lesions
On going, axillae, inframammary areas
Not scaly as areas are moist
How is flexural psoriasis treated?
Mild steroid and antifungal
as hard to distinguish from fungal infection
What is palmoplantar psoriasis?
U guess it
Psoriasis on the palms and soles - very sore
What is palmoplantar pustulosis?
Again u guessed it
Pustules on the palms and soles
Sterile and fade to brown macules over a few days
Palmoplantar pustulosis is strongly associated with alcohol T/F
False
Associated strongly with smoking
Which sex is palmoplantar pustulosis more common in?
Females
What is erythodermic psoriasis?
When over 90% of the skin surface is red
How is erythrodermic psoriasis treated?
Fluid balance correction
Bed rest
Emollients
Systemic immunosuppression
What is the main concern in generalised pustular psoriasis?
Development of an infection
How does coal tar work to treat psoriasis?
Reduces DNA synthesis and epidermal proliferation
How does dithranol work to treat psoriasis?
Reduces epidermal proliferation via anti-mitotic mechanism
What is the main problems with coal tar?
Brown and smells
What is the main problem with dithranol?
Burns normal skin
Can stain
