A case of plaque psoriasis

Question 1

Factors that may exacerbate psoriasis (6)

Answer 1

1. stress
2. Infection (streptococcal and fungal)
3. Medication (lithium, beta-blockers, anti-malarials, ACE inhibitors, steroid withdrawal)
4. Smoking/alcohol
5. Skin injury (usually appears at site of injury)
6. hormonal changes - worse with puberty/menopause, better with pregnancy

Question 2

What treatments of psoriasis are commonly used in primary care?

Answer 2

1. emollients - soften the plaques.
2. vitamin d based creams - treatment of choice for plaque psoriasis.
3. topical steroids - used with caution for short periods. Stopping may cause rebound flare up. Useful with vitamin d cream.
4. salicyclic acid - lifts scales

Question 3

two treatments used by dermatologists for severe psoriasis

Answer 3

1.psoralen + UVA
(together PUVA)

2. Immune modulating drugs e.g. methotrexate and anti-TNF e.g. Etanercept. Side effects balanced with benefits