Psoriasis Flashcards
common denominator in psoriasiform skin disorders
scaly papules and plaques (papulosquamous)
immunopathogenesis of psoriasis
- environment triggering factors -> autoimmune, t-cell mediated response
- keratinocyte hyperproliferation and poor differentiation
- new vessel formation and vasodilation
- lead to erythema, thickening, and scaling
lesions in psoriasis
- hallmarks: erythema, thickening, scale
- sharply marginated, with silvery-white scale
notable signs in psoriasis
- auspitz’s sign (bleeding points)
- woronoff’s ring (blanching of erythematous skin at periphery of healing plaque)
distribution of psoriasis
- elbows, knees, extensor of limbs
- hands, feet, scalp
- lower lumbosacral, buttocks, genital
- symmetrical!!
what is koebner phenomenon
- lesions at sites of even trivial injury
- areas of frequent trauma, friction, and pressure
course of psoriasis
- recur and persists
- unpredictable course (remission and exacerbation)
t/f psoriasis only affects the skin
false, it’s a systemic inflammatory disease
most common type of psoriasis
chronic plaque or psoriasis vulgaris
what is guttate psoriasis
- scattered, discrete, red, 2-5 mm, well defined borders, silvery white scales
- generalized distribution on upper trunk and proximal extremities
an abrupt eruption of guttate psoriasis can occur after ___
acute infection (strep pharyngitis)
what is inverse psoriasis
- occurs in intertriginous areas
- minimal to absent scaling
- sharply demarcated erythema
what is localized pustular psoriasis
- palms and soles
- sudden onset of formation of lakes of pus
what is generalized pustular psoriasis
- waves of fever and eruption of 2-3 mm sterile pustules
- malaise, leukocytosis, hypocalcemia, generalized weakness
trigger for generalized pustular psoriasis
withdrawal of systemic corticosteroids
what is erythrodermic psoriasis
- sudden onset
- has fine, superficial scaling with erythema
- with chills and fever and lower extremity edema
complications of erythrodermic psoriasis
high output cardiac failure and impaired hepatic and renal function
manifestations of nail psoriasis
- distal onycholysis
- oil spots
- pitting
- subungual hyperkeratosis
- onychodystrophy
what is scalp psoriasis
- most common initial site
- scattered discrete plaques or involvement of entire scalp
t/f scalp psoriasis can extend beyond the hairline
true
what is psoriatic arthritis
- early: oligoarticular and polyarticular pain, tenderness and morning stiffness
- erosive change
- asymmetric distal interphalangeal joint involvement with nail damage
management for psoriasis
- stress management
- treat comorbids
- check for joint disease
medications for psoriasis
- topical treatment
- excimer laser
- phototherapy
- oral: methotrexate, acitretin, cyclosporin
- biologics (-mabs)
t/f guttate psoriasis can be self-limiting
t/f erythrodermic and guttate can evolve into chronic plaque psoriasis
t/f systemic steroids is recommended for psoriasis
true
true
false
