Psoriasis

Question 0

top causes of death with psoriasis

Answer 0

CVD> infection > cancer

Question 1

papulosquamous disease

Answer 1

inflammatory disorder characterized by scaly papules and plaques
–>scaly (abnormally thick, flaky startum corneum) +/- crust (dried blood and serum)

Question 2

what is the believed etiology of psoriasis

Answer 2

abnormal t cell function and communication (specifically Th17 and IL23)

Question 3

physical presentation of psoriasis

Answer 3

scalp, groin, extensor surfaces

Question 4

other organs psoriasis involves

Answer 4

nails: pitting + pil spotting
joints: Rh- arthritis

Question 5

Auspitz sign

Answer 5

plaque with silvery scale that pinpoint bleeds on removal

Question 6

4 clinical subtypes of psoriasis

Answer 6

plaque
guttate
erythrodermic
pustula

Question 7

plaque psoriasis

Answer 7

raised, red, sclay

elbows, knees, butt crack (80% of cases)

Question 8

guttate psoriasis

Answer 8

small dot like lesions usually secondary to staph superantigen

Question 9

tx of guttate psoriasis

Answer 9

penicillin

Question 10

erythrodermic psoriasis

Answer 10

intense redness, inflammatory scaling, loose heat and fluids

deep dermal redness

Question 11

pustual psoriasis

Answer 11

pus-filled lesion with some scaling; often localized to plams and soles
–appear brown, but still surrounded by ham lesions

Question 12

pattern erythrodermic subtype follows

Answer 12

progressive; knees up

Question 13

inverse psoriasis

Answer 13

targets skin fold areas INSTEAD of extensor surfaces

increases with topical steroids which promote yeast growth

Question 14

tx of psoriasis

Answer 14

topicals: for mild-moderate psoriasis- coal tar, anthral, topical steroid, vitD
photorx: moderate severe or localized tough plaque: UVB, PUVA (psoralen + UVA)
systemics
biologics

Question 15

systemic treatments

Answer 15

MTX
cyclosporine
acitretin (retinoid)b

Question 16

biologics

Answer 16

anti-t cell therapies
anti-tnfa
new drugs focusing on Th17 and IL17a

Question 17

PASI score

Answer 17

scale ranging from 0-72 based on area involved by region and severity of process, want to improve by greater/ 75%

Question 18

seborrheic dermatitis

Answer 18

pityrosporum yeast infection which infests sebaceous glands

Question 19

clinical prsesentation of seborrheic dermatitis in adults

Answer 19

moist, transparent-tellow greasy scaling papules in ares where seb glands are maximum

tends to have a chronic course with remissions and exacerbations

Question 20

seborrheic derm is similar to

Answer 20

rosacea, but rosacea has scales

Question 21

where do you typically find seborrheic dermatitis

Answer 21

scalp margins, central face, presternal ares, eyebrows, face and eyelashes, nasolabial folds and paranasla skin, external ear canals

Question 22

seborrheic dermatitis in infants

Answer 22

“cradle cap”–minimal underlying redness that usually resolves sponatenously–>need to get it off!

Question 23

pityriasis rosea

Answer 23

common, self limited, usually post viral xanthem

Question 24

age of pityriasis rosea

Answer 24

10-35 years

Question 25

clinical presentation of pityriasis rosea

Answer 25

``` hearld patch (first lesion, salmon colored with trailing scale) 1-2 weeks later: explosive, x mas tress dist of smaller lesions that resolve without scar ```

Question 26

PR follows

Answer 26

URI

Question 27

lichen planus

Answer 27

uncommon, inflammatory PSD with unknown etiology

Question 28

what body parts does lichen planus effect

Answer 28

skin nails hair mucous membranes

Question 29

clinical presentation of lichen planus

Answer 29

itching, intermittent and insatiable purple, polygonal, pruritic, papules, plaques wickham's striae

Question 30

wickham;s striae

Answer 30

lacy reticulated

Question 31

koebner phenomenon

Answer 31

lesions develop in areas of injury | unique to PSD

Question 32

in 3% of cases, severe oral lichen planus can degenerate to

Answer 32

sqaumous cell

Question 33

lichen schelorisis

Answer 33

chronic PSD of unknown etio | much more common in women over 60 but can occur at angy age

Question 34

what does lichen sclerosus effect

Answer 34

skin and mucosal surfaces

Question 35

skin lesions in lichen clerosus are usually

Answer 35

asymptomatic

Question 36

clinical presentation for women in lichen sclerosus

Answer 36

women complain of chronic vulvar pruritis, dysuria or dyspareunia (chronic scarring)

Question 37

clinical presenation for men in lichen sclerosus

Answer 37

persistent balanitis (swlling of head of penis)-->if untreated can progress to phimosis (inability to retract foreskin and even erectile dysfunction)

Question 38

lichen sclerosus is considered

Answer 38

pre-cancerous--squamous cell carcinoma in 3% of lesions