Psoriasis - AMS Flashcards
What is Psoriasis?
- Immune-mediated cutaneous disorder that triggers epidermal proliferation
- Lifelong, non-contagious,
- Caused by rapidly growing skin cells
During which season is psoriasis worse? Better?
- Psoriasis improves in summer sunlight
- Worse in winter → dry skin leads to epidermal injury
What are contributing factors to psoriasis?
- Environmental factors
- Stress
- Medications or concurrent infections (lithium, beta blockers, NSAIDS, antimalarials)
- Trauma
- Smoking & ETOH
“Von Zumbusch” is a rare, acute generalized variant of what type of psoriasis?
Pustular psoriasis
What category of psoriasis is associated with antecedent streptococcal infections?
-Guttate psoriasis → typically responds better to steroids than plaque
What is Auspitz’s sign?
-Adherent, silvery white scale that leads to bleeding points when removed
What is Koebner’s phenomena?
Psoriasis occurring at sites and in shape of physical trauma (elbows, knees, scalp, gluteal cleft, nail beds)
What are the histological hallmarks of psoriasis?
- Hyperproliferation of epidermal cells who’s normal turnover rate accelerates by a factor of 10
- Hyperkeratinization with poor cellular differentiation
- Marked thickening of stratum corneum
What is the most common form of psoriasis?
Plaque (90%)
On what surface is psoriasis most common; extensor or flexor?
extensor surfaces
What are the 3 types of psoriatic arthritis?
1) oligoarthritis (70%) → skin lesions precede arthritis
2) Symmetrical polyarticular → mimics RA
3) Arthritis mutilans
What is the Tx of Psoriatic Arthritis?
- GOLD: chrysotherapy
- DMARDs: Enbrel, Humira, Remicade, Stelara
- Methotrexate
What are the principles of treatment for Psoriasis?
- Control Stress
- Determine end of treatment
- Topicals (mild to moderate)
- Systemics (moderate to severe)
What are topical treatment options for psoriasis?
- Corticosteroids (Group I-VII)
- Calcipotriene (Dovonex): Vitamin D3 analogue → inhibits epidermal cell proliferation
- Tazarotene (Retinoid): may prevent corticosteroid atrophy
Before applying topical treatments for psoriasis (calcipotriene/Anthralin), what should be suppressed first?
Inflammation → red sore plaques can be irritated by topical therapy
