psoriasis

Question 1

genes assoc with psoriasis

Answer 1

HLA B13, B17, identical twins

Question 2

cell pathophysiology psoriasis

Answer 2

T cells stimulate kertatinocytes proliferation

Question 3

which T cells in psoriasis

Answer 3

Th17, Th1, Th2

Question 4

chronic plaque psoriasis

Answer 4

well demarcated // red plaques with white scale // extensors, sacrum, scalp

Question 5

flexural psorasis

Answer 5

skin is smooth

Question 6

pustular psoriasis

Answer 6

hands and feet

Question 7

guttate psorasis

Answer 7

transient, small tear trop, psoriatic rash on trunk and limbs

Question 8

what precipitates guttate psoriasis + how long does it lasts

Answer 8

strep infection 2-4 weeks prior // lasts 2-3 montgs

Question 9

mx guttate psoriasis

Answer 9

topical psorasis mx // UVB // tonsillectomy

Question 10

what is koebners phenomenon

Answer 10

skin lesions that appear at site of injury

Question 11

aside from psoriasis when is koebners phenomenon seen

Answer 11

vitiligo, warts, lichen planus, lichen slcerosis, molluscum

Question 12

what is auspitz sign

Answer 12

removing a plaque in –> pinpoint bleeding

Question 13

common nail symptoms psoriasis

Answer 13

pitting, oncholysis, subungal hyperketatosis, loss of nail

Question 14

what type of psoriasis is most assoc with nail chnages

Answer 14

psoriatic arthroplasty (80-90%)

Question 15

exacerbating factors psoriasis

Answer 15

trauma, alcohol, meds, withdrawal from steroids

Question 16

what meds can trigger psoriasis

Answer 16

BB, lithium, alcohol, NSAIDS, chloroquine, ACEi, infliximab

Question 17

in psoriatic arthropathy what is the first symptoms

Answer 17

unilateral arthritis

Question 18

1st line mx chronic plaque psoriasis

Answer 18

potent steroid + Vit D analogue (calcipotriol) once daily at different times for 4 weeks

Question 19

2nd line topical mx chronic plaque psoriasis + when is it offered

Answer 19

no improvement 8 weeks –> Vit D analogue twice a day

Question 20

3rd line topical mx chronic plaque psoriasis + when is it offered

Answer 20

no improvement 8-12 weeks –> potent steroid BD for 4 weeks OR tar daily OR dithranol

Question 21

phototherapy for chronic plaque psoriasis

Answer 21

UVB light, photochemotherapy

Question 22

SE phototherapy

Answer 22

ageing, SCC

Question 23

systemic therapy chronic plaque psoriasis

Answer 23

1 = methotraxte // others = ciclopsorin, retinoids, infiliximab

Question 24

mx scalp psoriasis

Answer 24

potent topical steroids OD 4 weeks (betnovate)

Question 25

mx face, flexure + groin psoriasis

Answer 25

mild or moderate steroid BD 2 weeks

Question 26

SE topical steroids

Answer 26

atrophy, striae, rebound symptoms

Question 27

how long after a course of topical steroids can another be started

Answer 27

4 weeks minimum

Question 28

how long can topical steroids be used

Answer 28

mild - 8 weelks // potent = 4

Question 29

how long can Vit D analogues be used

Answer 29

long term

Question 30

when is vit D contraindicated

Answer 30

pregnancy

Question 31

mechanism vit D

Answer 31

decreased cell division –> decreased epirdermal proliferation

Question 32

what is Vit D particularly good at in psoriasis

Answer 32

reducing scale (not redness)

Question 33

downsides tar and dithranol

Answer 33

tar stains + dithranol smells

Question 34

mechanism dithranol

Answer 34

inhibits DNA synthesis