Psoriasis and Red Scaly Rash

Question 1

Psoriasis is a chronic disease with predominantly __ and __ involvements.

Answer 1

skin and joint

Question 2

Onset occurs in 2 peaks:

Answer 2

between 20-30, then 50-60

Question 3

The classification of psoriasis is based on 1; they include (name 5); clinically they often overlap

Answer 3

1. morphology

Plaque, inverse/flexural, guttate, erythrodermic, pustular

Question 4

1 psoriasis are rare and can often be triggered by 2. They can be palmoplantar, which can be either 3 or 4.

Answer 4

1. pustular
2. corticosteroid withdrawal
3. plaque type
4. pustular type

Question 5

Guttate psoriasis have 1 onset and are 2 sized lesions on 3 and 4. They are often preceded by 5.

Answer 5

1. acute
2. raindrop
3. trunk
4. extremities
5. Strep Pharyngitis

Question 6

1 lesions are erythematous plaques in the 2 and may lack 2 due to moistness of the area

Answer 6

1. Inverse/flexural

2. scales

Question 7

1 involves entire skin surface with the skin being bright red. It’s associated with 2 and like pustular psoriasis, hospitalization is sometimes required.

Answer 7

1. Psoriatic erythroderma

2. fever, chills, malaise

Question 8

Plaque psoriasis is the most common form, characterized by 1 scale and underlying 2; they can commonly be on the 3 and is typically 4 and 5, and 10% to 25% are associated with 6. There can also be 7 phenomenon (lesion induced by scratching/trauma)

Answer 8

1. silvery scale
2. erythema
3. elbow
4. symmetric
5. bilateral
6. psoriatic arthritis
7. Koener phenomenon

Question 9

The pathogenesis of plaque psoriasis is the 1 state resulting in excess scale and thick skin, mediated by 2 released by immune cells; they can be triggered by 3 and are more severe in 4 pt, with 20% having 5. There’s a positive correlation with increased 6 with prevalence and severity. Pt with psoriasis may also be at increased risk for 7.

Answer 9

1. hyperkeratinic
2. cytokines
3. preceding strp pharyngitis infection
4. AIDS
5. psoriatic arthritis
6. BMI
7. Cardiovascular disease

Question 10

Psoriasis can be triggered by medications such as 1, 2, 3, 4, 5

Answer 10

1. beta blockers
2. lithium
3. antimalarial
4. corticosteroids
5. IFN

Question 11

1/3 of psoriasis pt have positive __ history

Answer 11

family

Question 12

Behavioral risk factors for psoriasis include __ and __

Answer 12

smoking and alcohol

Question 13

Nail psoriasis is linked with 1 and can be 2, which shows as punctate depression of nail plate surface, 3, which is the separation of nail plate from nail bed, 4, and 5.

Answer 13

1. psoriatic arthritis
2. pitting
3. oncholysis
4. subungual hyperkeratosis
5. trachyonoychia

Question 14

Psoriatic arthritis occurs in __ of ptn with psoriasis and is not related to __ of psoriasis. There are five clinical patterns, most common ones being __ and __

Answer 14

1. 10 to 25%
2. severity
3. oligoarthritis
4. tenosynovitis

Question 15

For psoriasis <5% BSA (localized), 1 is the best treatment, and it is much better with 2 which allows for better penetration

Answer 15

1. topical

2. occlusion

Question 16

Systemic treatment of psoriasis should be 1 with 2 and 3 should never be used with plaque psoriasis

Answer 16

1. supplemented
2. topical tx
3. oral steroids

Question 17

The best test to confirm the diagnostic of fungal infection is __

Answer 17

KOH exam

Question 18

Tinea corporis classically present as 1 with peripheral 2 at the 3 and central 4. It is caused by 5 and these dermatophytes appear as translucent branching and septate hyphae.

Answer 18

1. annular patches
2. scaling
3. advancing edge
4. clearing
5. Trichophyton and Microsporum

Question 19

Fungus that lessen in redness with topical steroids are 1. Scaly rashes not responding to steroids, 2 should be done

Answer 19

1. Tinea incognito

2. KOH exam

Question 20

Azoles are 1 and allylamines are 2. Extensive involvement may involve tx with 3 ( )

Answer 20

1. fungistatic
2. fungicidal
3. oral antifungals terbinafine 14-28 days

Question 21

Pityriasis rosea is an 1 mainly occurring in 2. It’s usually 3 but may have associated 4. The eruptions usually start with 5 that has peripheral 6 and central 7. The secondary phase erupts in 8 that follow 9 giving the 10 appearance.

Answer 21

1. acute exanthematous eruption
2. young people btw 10-25 yrs
3. asymptomatic
4. flu like symptoms
5. herald’s patch
6. scaling
7. clearing
8. symmetrically over trunk and proximal extremities
9. loosely skin lines
10. christmas tree

Question 22

Treatment of pityriasis rosea is mainly supportive 1. It usually resolves in 2

Answer 22

1. anti-itch lotion

2. 5-8 wks

Question 23

Primary syphilis begins with 1 and secondary phase comes 2 later. Prodromes include 3, and clinical rashes of secondary syphilis are presented on 4.

Answer 23

1. chancre, painless, often goes unnoticed
2. 1-2 wks later
3. fever, malaise, HA, stiff neck
4. trunks, extremities, and palms and soles; variated in size, shape, can have scales; can look like “christmas tree” but with palm soles and mouth involvement

Question 24

Diagnosis for Syphilis is 1 and treatment is 2

Answer 24

1. serologic test

2. intramuscular benzathine Pen G

Question 25

Guttate psoriasis present as 1 and often follow 2. Treatment for limited psoriasis is 3 while for extensive psoriasis, 4 helps

Answer 25

1. small, rain drop like scaly papules and plaques mostly on trunk and extremities
2. GAS strep infection
3. topical steroid 1-2x daily
4. narrow band UVB, no immunosuppression

Question 26

Lesions of nummular dermatitis?

Answer 26

multiple coin sized eczematous plaque on extermities and trunk;

no central clearing seen in tinea corporis

KOH neg

very pruitic

weeping, cracking, vesicles, crusts

pathology: spongiotic dermatitis

Question 27

Treatment for nummular dermatitis?

Answer 27

Flucocinonide ointment, treat like atopic dermatitis/eczema. 2x day

Question 28

5 common causes of papulosquamous eruptions

Answer 28

tinea corpors
pityriasis rosea 
2nd syphilis 
psoriasis
nummular dermatitis