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PHAR154 > Psoriasis > Flashcards

Psoriasis Flashcards

(44 cards)

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1
Q

Which HCPs are the most involved in psoriasis care?

A

MD

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2
Q

What is psoriasis?

A

skin disease that causes red, itchy, scaly patches
scales are silvery
long-term disease
tends to go through cycles
no cure

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3
Q

What are the most common spots for psoriasis?

A

knees
elbows
trunk
scalp

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4
Q

Which form of psoriasis accounts for 90% of cases?

A

plaque psoriasis
-scales, silvery, above plane of skin

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5
Q

Which form of psoriasis is tougher to treat?

A

scalp psoriasis
-epithelium on scalp is thicker

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6
Q

What do the nails of psoriasis patients tend to look like?

A

they have tiny pits

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7
Q

Which forms of psoriasis are less common and well beyond our scope of practice?

A

guttate
pustular
palmo-plantar
erythrodermic

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8
Q

True or false: sunlight worsens psoriasis

A

false
UV light therapy is helpful

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9
Q

What can worsen psoriasis?

A

cold weather
stress
trauma

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10
Q

How bad is the scarring that results after lesions resolve?

A

there is no scarring as the lesions resolve

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11
Q

What is the etiology of psoriasis?

A

autoimmune (T-cell and TNF dysfunction)
genetic + environmental factors
12x the normal rate of skin cell production

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12
Q

What are the impacts of psoriasis?

A

can be physically debilitating
social aspects (especially if on scalp)
risk factor for many other diseases
1 million Canadians impacted

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13
Q

What is central to the skin care routine of psoriasis patients?

A

emollients/standard dry skin products (eczema-grade)

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14
Q

How are emollients used for psoriasis?

A

PRN between flares

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15
Q

What is the main use of keratolytics for psoriasis?

A

salicylic acid can loosen scales thus enhancing steroid penetration (combo Rx product)
-Diprosalic and Nerisalic
-keratolytics are very mild agents on their own

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16
Q

What are the properties of tar in treatment of psoriasis?

A

anti-proliferative (decrease skin turnover)
OTC shampoos for mild cases are common

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17
Q

What are the side effects of tar shampoos?

A

irritating
smell (hospital)
folliculitis

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18
Q

What are the directions for use of T Gel?

Study These Flashcards
A

leave on for several minutes
use at least 2x/week

19
Q

What is the mainstay of therapy for psoriasis?

Study These Flashcards
A

topical steroids
-can have 2 agents if patient can afford it
USED IN COMBO WITH OTHERR AGENTS

20
Q

What is used to decreased steroid use in psoriasis?

Study These Flashcards
A

dry skin lotions
-steroid sparing
-separate application by 1 hour

21
Q

What strength of steroid is needed for psoriasis?

Study These Flashcards
A

mid-potency (except for face and skin folds)
-scalp is tougher to treat, may need stronger steroid

22
Q

Why should you not stop topical steroid treatment suddenly in psoriasis?

Study These Flashcards
A

rebound flare-up
-use every 2 or 3 days for one week

23
Q

What are the side effects of topical steroids?

Study These Flashcards
A

skin atrophy
telangiectasia
striae
rebound flare-ups on sudden d/c (psoriasis specific)

24
Q

Which phase of psoriasis needs a lighter steroid? Which stage needs a heavier steroid?

Study These Flashcards
A

lighter: acute phase (skin is easier to penetrate)
heavier: healing phase (tougher barrier)

25
What is calcipotriol?
vitamin D analogue that is very popular for psoriasis decreases skin turnover used in mild-moderate cases
26
How long does it take for calcipotriol to show results?
2 weeks -slower than a steroid
27
What are some precautions to take with calcipotriol?
not recommended for face max weekly guidelines: 100g cream, 60ml scalp lotion reports say to avoid vitamin D
28
What is the difference between Dovonex and Dovobet?
Dovonex: calcipotriene Dovobet: calcipotriol + betamethasone
29
What is the treatment for scalp psoriasis?
topicals regardless of severity -potent steroid>D analogue alone -D analogue COMBO>steroid alone
30
What are the side effects of vitamin D analogue combos for treatment of scalp psoriasis?
very low to placebo-like side effects
31
Are psoriasis agents used when skin is normalized?
psoriasis agents typically arent used preventatively -usually playing catch up
32
What is calcitriol and when is it used?
vitamin D analogue for psoriasis cases with up to 35% of affected body area max 30g/day
33
What is the action of retinoids for psoriasis?
utilizes retinoid receptor--> decrease cell proliferation indicated for face
34
Which retinoid is used for psoriasis?
tazarotene (mild to moderate cases) -concurrent use with steroid to decrease irritation
35
How long does it take for improvement for the following: calcipotriol/betamethasone, steroid monotherapy, vitamin D analogue monotherapy, retinoid monotherapy.
calc/betamethasone: 1 week steroid: varies vit D analogue: 2 weeks retinoid: 1-4 weeks
36
What is anthralin?
anti-mitotic agent that is not commonly used in Canada for psoriasis -vit D analogues and steroids are better
37
How does phototherapy help treat psoriasis?
UVB and PUVA rapidly decrease cell proliferation
38
Describe narrow band UVB treatment for psoriasis.
2-3 a week more common than UVA (less se) can be done at home
39
Describe PUVA treatment for psoriasis.
go to clinic for treatment UVA needs photoactive agent (psoralen) treatment can be very itchy and need to avoid sunlight for a day after
40
Describe biologic agent treatment for psoriasis.
TNF-a/IL-23 antagonists severe cases injection and expensive worries about serious se, safety record is growing
41
What is the treatment for psoriatic arthritis?
cyclosporine methotrexate TNF-a blockers
42
What percentage of psoriasis sufferers have scalp involvement?
50-80%
43
Which area of the body do psoriasis lesions linger longer?
scalp
44
Which patients are typically candidates for phototherapy or systemic therapy?
>5% BSA -one hand is approximately 1% of BSA

PHAR154 (18 decks)

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