Unit 2 - Dermatology 2 Flashcards
What is the clinical appearance of Guttate
psoriasis?
Typically presents as small (1mm–10mm) oval, scaly, redto-pink plaques over the whole of the body. More common in children and young people, but can occur in adults and is often preceded by a streptococcal throat infection
What is the treatment for Guttate
psoriasis?
Although the condition can clear without treatment, ultraviolet (UV) therapy is often used two to three times a week for up to eight weeks
What are the clinical symptoms of Pustular
psoriasis?
Characterised by white pustules surrounded by inflamed skin. Often seen in adults; can be localised (hands/palms) or may cover most of the body (generalised pustular psoriasis). Patients develop inflamed skin and within hours develop pustules which can coalesce to form lakes of pus
What is the treatment for pustular psoriasis ?
Generalised pustular psoriasis is a medical emergency and death can occur through cardiorespiratory failure. Secondary management involves prevention of fluid loss, stabilising body temperature and correcting electrolyte balance
What is the clinical appearance of Inverse or
flexural psoriasis?
Affects intertriginous regions of the body (axilla, natal cleft, genital region). Typical appearance can be described as shiny red, well-defined lesions with no adherent scale
What is the treatment for Inverse or
flexural psoriasis?
Mild potency topical steroids often in conjunction with an anti-fungal agent, because of the potential for co-existant fungal infections. Vitamin D analogues such as calcitriol can also be used. However, patch testing a small area of skin first is useful because of the potential for irritation
What is the clinical appearance of Palmoplantar
pustular psoriasis?
Presents as a series of sterile
pustules occuring on the
hands (palms) and soles of the
feet
What is the treatment for Palmoplantar
pustular psoriasis?
A range of treatment options
have been used including
topical steroids, coal tar,
acitretin and phototherapy
What is the clinical appearance for Erythrodermic
psoriasis?
A generalised redness and shedding of the skin, can be described as looking like burnt skin. The condition can occur acutely or develop over a few days or even weeks
What is the treatment for erythrodermic psoriasis
A potentially life-threatening condition and requires hospitalisation. Treatment involves systemic psoriatic agent, combined with emollients, topical steroids and correction of fluid imbalances
What are the clinical symptoms of plaque psoriasis ?
Clinically, plaque psoriasis is characterised by well-defined erythematous, silvery-white
hyperkeratotic scaling plaques that occur on extensor surfaces of the body (e.g. elbows,
knees and the lower back), but psoriasis also affects the scalp. Many
patients also experience changes to their nails, including abnormal nail-plate growth
leading to characteristic pitting, a build-up of keratinous material underneath the nail
What are some counselling points pharmacists could give to patients with psoriasis?
Find an emollient or range of emollient products for washing and moisturising
that you like and suit you, and use them each day;
Moisturise your entire body (including psoriasis areas) each day using long,
smooth, soothing strokes (in the direction of hair growth);
Carry a small amount of moisturiser with you and apply to dry and itchy
plaques during the day;
Avoid scratching and picking;
Leave around 20–30 minutes between emollient and psoriasis topical
treatments, to aid the effectiveness of each;
Persevere with topical psoriasis treatments for at least one month — most take
around four weeks to begin to work;
Be aware that the scale will disappear first and the psoriasis may appear red —
this is normal and continuing with treatment will result in pink areas, which will
gradually fade to normal skin colour;
If you have scalp psoriasis, de-scale your scalp before applying topical
treatments. Remember to part the hair and treat the scalp;
Work out a good individual routine — emollients should be used daily and
psoriasis treatments only when condition is flaring;
Once the skin becomes flat, active treatments can be stopped, although you
should continue with emollients.
How does diet effect psoriasis ?
Patients may ask pharmacists about the role of diet in psoriasis and whether there are
specific foods that should be eaten or avoided. There is some evidence that consumption
of omega-3 fish oils can improve disease severity and that supplementing with oral
vitamin D could help, although the evidence from studies is less robust
