Psoriasis and Red Scaly Rash Flashcards
Psoriasis is a chronic disease with predominantly __ and __ involvements.
skin and joint
Onset occurs in 2 peaks:
between 20-30, then 50-60
The classification of psoriasis is based on 1; they include (name 5); clinically they often overlap
- morphology
Plaque, inverse/flexural, guttate, erythrodermic, pustular
1 psoriasis are rare and can often be triggered by 2. They can be palmoplantar, which can be either 3 or 4.
- pustular
- corticosteroid withdrawal
- plaque type
- pustular type
Guttate psoriasis have 1 onset and are 2 sized lesions on 3 and 4. They are often preceded by 5.
- acute
- raindrop
- trunk
- extremities
- Strep Pharyngitis
1 lesions are erythematous plaques in the 2 and may lack 2 due to moistness of the area
- Inverse/flexural
2. scales
1 involves entire skin surface with the skin being bright red. It’s associated with 2 and like pustular psoriasis, hospitalization is sometimes required.
- Psoriatic erythroderma
2. fever, chills, malaise
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)
- silvery scale
- erythema
- elbow
- symmetric
- bilateral
- psoriatic arthritis
- Koener phenomenon
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.
- hyperkeratinic
- cytokines
- preceding strp pharyngitis infection
- AIDS
- psoriatic arthritis
- BMI
- Cardiovascular disease
Psoriasis can be triggered by medications such as 1, 2, 3, 4, 5
- beta blockers
- lithium
- antimalarial
- corticosteroids
- IFN
1/3 of psoriasis pt have positive __ history
family
Behavioral risk factors for psoriasis include __ and __
smoking and alcohol
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.
- psoriatic arthritis
- pitting
- oncholysis
- subungual hyperkeratosis
- trachyonoychia
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 __
- 10 to 25%
- severity
- oligoarthritis
- tenosynovitis
For psoriasis <5% BSA (localized), 1 is the best treatment, and it is much better with 2 which allows for better penetration
- topical
2. occlusion
Systemic treatment of psoriasis should be 1 with 2 and 3 should never be used with plaque psoriasis
- supplemented
- topical tx
- oral steroids
The best test to confirm the diagnostic of fungal infection is __
KOH exam
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.
- annular patches
- scaling
- advancing edge
- clearing
- Trichophyton and Microsporum
Fungus that lessen in redness with topical steroids are 1. Scaly rashes not responding to steroids, 2 should be done
- Tinea incognito
2. KOH exam
Azoles are 1 and allylamines are 2. Extensive involvement may involve tx with 3 ( )
- fungistatic
- fungicidal
- oral antifungals terbinafine 14-28 days
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.
- acute exanthematous eruption
- young people btw 10-25 yrs
- asymptomatic
- flu like symptoms
- herald’s patch
- scaling
- clearing
- symmetrically over trunk and proximal extremities
- loosely skin lines
- christmas tree
Treatment of pityriasis rosea is mainly supportive 1. It usually resolves in 2
- anti-itch lotion
2. 5-8 wks
Primary syphilis begins with 1 and secondary phase comes 2 later. Prodromes include 3, and clinical rashes of secondary syphilis are presented on 4.
- chancre, painless, often goes unnoticed
- 1-2 wks later
- fever, malaise, HA, stiff neck
- 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
Diagnosis for Syphilis is 1 and treatment is 2
- serologic test
2. intramuscular benzathine Pen G
Guttate psoriasis present as 1 and often follow 2. Treatment for limited psoriasis is 3 while for extensive psoriasis, 4 helps
- small, rain drop like scaly papules and plaques mostly on trunk and extremities
- GAS strep infection
- topical steroid 1-2x daily
- narrow band UVB, no immunosuppression
Lesions of nummular dermatitis?
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
Treatment for nummular dermatitis?
Flucocinonide ointment, treat like atopic dermatitis/eczema. 2x day
5 common causes of papulosquamous eruptions
tinea corpors pityriasis rosea 2nd syphilis psoriasis nummular dermatitis
