Psoriasis Flashcards
Psoriasis risk factors
- Smoking
- Obesity
- Alcohol use
- Drugs: beta blockers, lithium, antimalarials
- Infections: Streptococccus (guttate psoriasis) and HIV
Typesof psoriasis
- Chronic plaque psoriasis
- Guttate psoriasis
- Pustular psoriasis
- Erythrodermic psoriasis
Chronic plaque psoriasis
- The most common type
- Usually symmetrically distributed
Scalp, extensor surfaces and gluteal cleft are commonly affected.
Intertriginous areas may also be affected. - Plaques are erythematous with sharply defined margins and silvery scale, pruritus is common
Types of psoriasis
- Chronic plaque psoriasis
- Guttate psoriasis
- Pustular psoriasis
- Erythrodermic psoriasis
Guttate psoriasis
- Abrupt appearance of multiple “drop like lesions” in the trunk and limbs
- Strong association with streptococcal infections.
Pustular psoriasis
- Can be life threatening
- The most severe form (von Zumbusch type) presents with acute onset of widespread erythema, scaling and sheets of pustules.
- May be associated with fever, diarrhea, leukocytosis and hypocalcemia, as well as renal, hepatic and respiratory abnormalities and sepsis.
- Triggered by pregnancy, infection and withdrawal of steroids
Eryhtrodermic psoriasis
- Generalized erythema and scaling of most or all the body surface.
- High risk of sepsis and electrolyte abnormalities
Comorbid disease in psoriasis
Psoriasis is a multisystem inflammatory disorder associated with obesity, metabolic syndrome, hypertension, diabetes, atherosclerosis, malignancy, hepatic and pulmonary disorders and psychiatric disease.
Psoriasis epidemiology screening tool (PEST)
- Have you ever had a swollen joint (or joints)?
- Has a doctor ever told you that you have arthritis?
- Do your fingernails or toenails have holes or pits?
- Have you had pain in your heel?
- Have you had a finger or toe that was completely swollen and painful for no apparent reason?
Subcorneal pustular dermatosis
- Recurrent eruptions of grouped superficial pustules favoring flexural surfaces and more common in middle-aged women
- Pustules are often arranged in annular, circinate or serpiginous configurations
- Large flaccid bullae containing sterile pus are also possible
- It can be associated with tumors, IBD and rheumatological diseases
- Treatment is with dapsone
Limited plaque psoriasis treatment
Topical corticosteroids and emollients
Alternatives: tar, topical retinoids (tazoretene), topical vitamin D and antralin
Moderate to severe plaque psoriasis
- Phototherapy if feasible
- If phototherapy not possible systemic agents such as retinoids, MTX, cyclosporin, apremilast, biological agents and deucravacitinib
- Topical treatments as adjuvants
Pytiriasis rubra pilaris
Its a rare papulosquamous disease that can cause large orange-red plaques with islands of spared skin, follicular papules and red-orange plaques, hyperkeratotic follicular papules or plantar and plantar hyperkeratosis
In addition to topical steroids, keratolytics and emollients, it usually requires systemic therapy.
Pytiriasis rotunda
Pityriasis rotunda is an uncommon acquired dermatosis related to a disorder of keratinization. It is characterized by hyperpigmented or hypopigmented, sharply defined, circular or oval scaly plaques of variable size, which develop on the trunk and proximal parts of the limbs.
What’s the different distribution between SLE and seborrheic dermatitis
Seborrheic dermatitis affects the nasal creases
