Psoriasis

Question 1

First-line treatment of plaque psoriasis?

Answer 1

Potent steroid od + vitamin D analogue od (applied at separate times during the day)

Question 2

Second-line treatment if no improvement after 8 weeks?

Answer 2

Vitamin D analogue twice daily

Question 3

Third-line treatment? (2)

Answer 3

Potent corticosteroid twice daily for up to 4 weeks

Coal tar preparation

Question 4

Options for secondary care management? (3)

Answer 4

Narrowband UVB
Psoralen + UVA
Systemic treatment- oral MTX, ciclosporin, biologics

Question 5

Management of face/flexural/genital psoriasis?

Answer 5

Mild or moderately potent corticosteroid for up to two weeks

Question 6

Management of scalp psoriasis? (2)

Answer 6

Advise to use coal tar shampoo
Potent topical corticosteroids once daily for up to four weeks
If no improvement try a different formulation or add alternative agent to remove adherent scale e.g. salicylic acid

Question 7

What proportion of body coverage with psoriasis should merit secondary care referral?

Answer 7

10%

Question 8

Drugs which exacerbate psoriasis? (4)

Answer 8

Beta blockers
Lithium
NSAIDs
ACE inhibitors

Question 9

Management of guttate psoriasis?

Answer 9

Conservative

Question 10

Guttate psoriasis is classically preceded by…

Answer 10

strep throat infection 2-4 weeks previously