Psoriasis Flashcards
(27 cards)
What is psoriasis
Chronic autoimmune disease characterised by well-dermarcated, erythematous scaly plaques
5 Types of psoriasis
Chronic plaque psoriasis.
Flexural psoriasis.
Guttate psoriasis.
Pustular psoriasis.
Generalised/erythrodermic psoriasis.
What is chronic plaque psoriasis
Commonest type and causes symmetrical plaques on the extensor surfaces of the limbs, scalp and lower back
What is flexural psoriasis
Smooth erythematous plaques without scale in flexures and skin folds
What is gluttate psoriasis
Multiple small, tear-drop shaped, erythematous plaques occuring on trunk after strep infection in young adults
What is pustule psoriasis
Multiple petechiae and pustules on the palms and soles
What is generalised/erythrodermic psoriasis
Rare but serious form characterised by erythroderma nad systemic illness
Cutaneous features of chronic plaque psoriasis
Itchy, well-dermacated circular-to-oval bright red/pink elevated lesions with overlying white or silvery scale. Distributed symmetrically over extensor body surfaces and scalp
Nail changes in patients with psoriasis
Nailbed pitting, onycholysis, subungual hyperkeratosis
Risk factors for tirggering psoriasis
Skin trauma, infection (HIV, strep), Drugs, withdrawal of steroids, stress, alcohol and smoking, cold/dry weather
What are the risk f actors for developing psoriasis
Fhx, HIV infection, obesity and smoking
What is the Koebner phenomenon
Where skin lesions occur at sites of skin injury in otherwise healthy skin. Common psoriasis trigger.
What other diseases cause the Koebner phonomenon
Viral warts and vitiligo
Differentials for scaly skin rash
Pityriasis rosea, tinea, seborrhoeic dermatitis, Bowen’s disease, Discoid eczema, mycosis fungoides, discoid lupus, scabies
Management of plaque psoriasis
Corticosteroids to reduce inflammation.
Vitamin D reduces keratinocyte proliferation.
Management of flexural psoriasis
Topical corticosteroid
1st line topical optios
Potent topical corticosteroid OD (Betnovate) + topical vitamin D OD (Dovonex)
2nd ine topical options
Stop topical corticosteroid and use vit D topical twice daily
3rd line topical options
Stop topical vitamin D and apply corticosteroid twice daily
Phototherapy options
Narrowband UVB photopherapy and then psoralen + UVA
Systemic treatments
1st line - methotrexate
2nd line - ciclosporin
3rd line - acitretin
Biological treatments
Infliximab, Etanercept and Adalimumab
Topical corticosteroid potencies
Mild, moderate, potent and very potent
Eg of mild topical corticosteroid
Hydrocortisoe 0.5%
