Psoriasis Flashcards
(13 cards)
Which psoriasis is characterised by symmetrical, scaly plaques on extensors, scalp and lower back?
Chronic plaque psoriasis
Which psoriasis is characterised by smooth non-scaly erythematous plaques in skin folds?
Flexural psoriasis
Which psoriasis is characterised by small, tear drop shaped erythematous plaques on the trunk after a Streptococcal infection?
Guttate psoriasis
Which psoriasis is characterised by petechiae and pustules on fingers and toes?
Pustular psoriasis
Which psoriasis is characterised by psoriasis with erythroderma and systemic illness?
Erythrodermic psoriasis
Causes of psoriasis?
Skin trauma (Koebner phenomenon)
Streptococcus, HIV
BB’s, anti malarials, lithium, indomethacin, NSAIDs (BALIN)
Steroid withdrawal
Alcohol, smoking
Stress
Cold weather
Management of chronic plaque psoriasis?
Emolient +/- tar and dithranol, and…
1st line: topical steroid e.g. Betnovate + topical vitamin D applied at different times
2nd line: only topical vitamin D twice daily
3rd line: only high dose topical steroid twice daily
4th line (phototherapy): Narrowband UVB or Psoralen + UVA
5th line (systemic treatment):
- 1st line: methotrexate
- 2nd line: ciclosporin
- 3rd line: Acitretin
6th line - biologics
Side effects of methotrexate?
What must you monitor regularly when taking methotrexate?
Pneumonitis
Hepatotoxicity
Pancytopenia
Monitor FBCs
Side effects of acitretin?
Teratogenic
Hepatotoxicity
Hyperlipidaemia
Side effects of adalimumab?
What must you do before initiating this treatment?
Reactivation of latent TB
Do CXR
Side effects of ciclosporin?
What must you monitor during this treatment?
5 Hs:
Hypertrophy gums
Hypertrichosis
Hypertension
Hyperkalaemia
Hyperglycaemia
Monitor U&Es, blood glucose and BP
Management of scalp psoriasis?
1st line: Potent topical steroids once daily for 4 weeks
2nd line: use steroids in different formulation, e.g. shampoo, and/or salicylic acid/emollients/oils before applying steroids
Management of face, flexural and genital psoriasis?
Mild-moderate dose topical steroids once daily for 2 weeks
