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15 Derma > Psoriasis > Flashcards

Psoriasis Flashcards

1
Q

common denominator in psoriasiform skin disorders

A

scaly papules and plaques (papulosquamous)

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2
Q

immunopathogenesis of psoriasis

A
  • environment triggering factors -> autoimmune, t-cell mediated response
  • keratinocyte hyperproliferation and poor differentiation
  • new vessel formation and vasodilation
  • lead to erythema, thickening, and scaling
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3
Q

lesions in psoriasis

A
  • hallmarks: erythema, thickening, scale

- sharply marginated, with silvery-white scale

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4
Q

notable signs in psoriasis

A
  • auspitz’s sign (bleeding points)

- woronoff’s ring (blanching of erythematous skin at periphery of healing plaque)

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5
Q

distribution of psoriasis

A
  • elbows, knees, extensor of limbs
  • hands, feet, scalp
  • lower lumbosacral, buttocks, genital
  • symmetrical!!
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6
Q

what is koebner phenomenon

A
  • lesions at sites of even trivial injury

- areas of frequent trauma, friction, and pressure

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7
Q

course of psoriasis

A
  • recur and persists

- unpredictable course (remission and exacerbation)

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8
Q

t/f psoriasis only affects the skin

A

false, it’s a systemic inflammatory disease

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9
Q

most common type of psoriasis

A

chronic plaque or psoriasis vulgaris

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10
Q

what is guttate psoriasis

A
  • scattered, discrete, red, 2-5 mm, well defined borders, silvery white scales
  • generalized distribution on upper trunk and proximal extremities
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11
Q

an abrupt eruption of guttate psoriasis can occur after ___

A

acute infection (strep pharyngitis)

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12
Q

what is inverse psoriasis

A
  • occurs in intertriginous areas
  • minimal to absent scaling
  • sharply demarcated erythema
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13
Q

what is localized pustular psoriasis

A
  • palms and soles

- sudden onset of formation of lakes of pus

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14
Q

what is generalized pustular psoriasis

A
  • waves of fever and eruption of 2-3 mm sterile pustules

- malaise, leukocytosis, hypocalcemia, generalized weakness

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15
Q

trigger for generalized pustular psoriasis

A

withdrawal of systemic corticosteroids

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16
Q

what is erythrodermic psoriasis

A
  • sudden onset
  • has fine, superficial scaling with erythema
  • with chills and fever and lower extremity edema
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17
Q

complications of erythrodermic psoriasis

A

high output cardiac failure and impaired hepatic and renal function

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18
Q

manifestations of nail psoriasis

A
  • distal onycholysis
  • oil spots
  • pitting
  • subungual hyperkeratosis
  • onychodystrophy
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19
Q

what is scalp psoriasis

A
  • most common initial site

- scattered discrete plaques or involvement of entire scalp

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20
Q

t/f scalp psoriasis can extend beyond the hairline

A

true

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21
Q

what is psoriatic arthritis

A
  • early: oligoarticular and polyarticular pain, tenderness and morning stiffness
  • erosive change
  • asymmetric distal interphalangeal joint involvement with nail damage
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22
Q

management for psoriasis

A
  • stress management
  • treat comorbids
  • check for joint disease
23
Q

medications for psoriasis

A
  • topical treatment
  • excimer laser
  • phototherapy
  • oral: methotrexate, acitretin, cyclosporin
  • biologics (-mabs)
24
Q

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

A

true

true

false

25
Q

lesions in pityriasis rosea

A
  • herald patch: pink/ salmon oval patch collarette scale

- generalized eruption

26
Q

distribution of pityriasis rosea

A
  • trunk and proximal extremities
  • spares sun exposed surfaces
  • usually palms and soles spared
  • follows langer lines
27
Q

course of pityriasis rosea

A
  • herald patch
  • eruption
  • self limiting (3-5 wks)
28
Q

differentials for pityriasis rosea herald patch

A
  • tinea corporis (fungal - koh)

- nummular eczema

29
Q

differentials for pityriasis rosea generalized eruption

A
  • morbilliform eruption (drug or viral)
  • pityriasis versicolor (fungal - koh)
  • pityriasis lichonoides chronica (>8 wks, biopsy)
30
Q

psoriasis vs pityriasis rosea

A

read

31
Q

management for pityriasis rosea

A
  • oral antihistamines
  • topical steroids
  • oral erythromycin
  • phototherapy/ natural sungligh
  • oral steroids
  • acyclovir
32
Q

stages of syphilis

A
  • primary: chancre
  • secondary: 3-10 wks later, disappears in 3-12 wks
  • latent
  • tertiary
33
Q

clinical manifestations of secondary syphilis

A
  • systemic symptoms
  • rash
  • lymphadenopathy
  • mucosal ulceration
  • pruritic
34
Q

lesions in secondary syphilis

A
  • dull-red, raw ham, or coppery
  • biett collarette: white scaly ring on surface of papulosquamous lesions
  • mucous patches
  • condyloma lata on intertriginous areas
  • moth eaten alopecia
35
Q

distribution of secondary syphilis

A
  • symmetric on trunk and flexors of limbs

- palms and soles

36
Q

course of secondary syphilis

A
  • resolve 4-12 wks after appearance

- may relapse

37
Q

tests for secondary syphilis

A
  • dark field miicroscopy
  • nontreponemal tests: vdrl, rpr
  • treponemal tests: tpha, fta-abs
  • skin biopsy
38
Q

purpose of non-treponemal tests and treponemal tests

A

non-treponemal: screening and monitoring treatment (inc or dec in titer)

treponemal: confirmation of reactive non-treponemal tests, positive indefinitely

39
Q

what is the prozone phenomenon

A

false negative result due to high titers of antibody

40
Q

pharmacologic management of syphilis

A
  • im penicillin g
  • doxycycline, tetracycline, ceftriaxone, azithromycin
  • jarisch-herxheimer reaction: febrile reaction after initial dose of anti-syphilitic treatment
41
Q

clinical management of syphilis

A
  • reexamine serologically at 3 and 6 mos
  • test for hiv
  • test sexual partners
42
Q

secondary syphilis vs psoriasis vs pityriasis rosea

A

read

43
Q

what is seborrheic dermatitis

A
  • chronic, superficial, inflammatory disease
  • redness and scaling
  • dandruff
  • associated with parkinson’s and hiv
44
Q

etiology of seborrheic dermatitis

A

convergence of:

  • sebum
  • microbial effects (malassezia yeasts) degrade sebum, freeing irritating fatty acids
  • inflammation and scalp hyperproliferation
  • other aggravating factors
45
Q

lesions in seborrheic dermatitis

A
  • sharply demarcated patches or thin plaques

- pink-yellow, dull-red, red-brown

46
Q

distribution of seborrheic dermatitis

A
  • areas rich in sebaceous glands
  • face
  • occiput and neck
  • can lead to erythroderma
47
Q

course of seborrheic dermatitis

A
  • chronic relapsing course

- aggravating: perspiration, stress, drugs

48
Q

t/f extensive, severe, and therapy resistant seborrheic dermatitis should raise suspicion of hiv infection

A

true

49
Q

management of seborrheic dermatitis

A
  • mainstay: tropical azoles
  • antifungals: ketoconazole, miconazole, clotrimazole
  • low potency corticosteroids
  • emollients
  • topical calcineurin inhibitors
50
Q

seborrheic dermatitis vs psoriasis

A

read

51
Q

scalp psoriasis vs seborrheic dermatitis

A

read

sd doesn’t extend beyond hairline, can have involvement of retroauricular fold

52
Q

what is infantile seborrheic dermatitis

A
  • one week after birth or several months
  • greasy scales on vertex and anterior fontanelle
  • cradle cap
53
Q

infantile seborrheic dermatitis vs infantile atopic dermatitis

A

read

15 Derma (7 decks)

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