Example of a strong steroid
bethamethasone - betnovate
Features of psoriasis presentation
Scaley, silvery white plaques which may be mildly to severely itchy. In severe itching the skin may develop painful cracks and fissures
Nail psoriasis is associated with...
Commonly associated with flexural psoriasis?
Nail psoriasis presents as...
pitting, onycholysis, yellowing and ridging
Example of a mild steroid
Histology showing which skin disease
Why would oral steroids not be used in severe psoriasis?
may cause rebound flare up when steroids are stopped.
Where is palmoplanter psoriasis found?
palms and soles of the feet - may cause painful fissuring
Most common locations for psoriasis
knees, elbows, scalp
Condition seen here
Example of anti-TNF agents
In more extensive/severe psoriasis, what other treatments might be used?
UVB phototherapy, methotrexate, azathioprine, 6-mecaptopurine, biologics
Conditions associated with psoriasis (6)
inflammatory arthritis; spondyloarthropathy; IBD; Uveitis; Coeliac disease; Metabolic syndrome
Description of psoriasis
chronic, inflammatory skin condition with well-defined red and scaly plaques on the extensor surfaces
Key immune factors in psoriasis
Th17, IL-1b, TNFa
Acute form of psoriasis
Associated with streptococcal infections
Example of a very potent steroid
Key disease process in psoriasis
What is the Koebner phenomenon?
new psoriatic lesions form in areas of cutaneous injury but otherwise healthy tissue; often linear in shape and not found where psoriasis may normally be found
painless separation of the nail from the nail bed often starting at the tip
Presentation of guttate psoriasis...
widespread small plaques
Guttate psoriasis is commonly associated with...
Topical treatments for mild/moderate psoriasis (6)
coal tar, emollients, calcipotriol, steroids, calcineurin inhibitor, salicylic acid
Peak onset for psoriasis (2)
15-25years; 50-60 years
Clinical sign seen here
Example of a moderate steroid
Where would flexural psoriasis commonly be found?
in the body folds and around the genitals
General advice for psoriasis
stop smoking and drinking, maintain a healthy weight