Flashcards in Psoriasis Deck (10):
What is the general appearance of psoriasis? Symptoms/signs
Sharply demarcated erythematous plaque with micaceous scale
Numerous and small, widely disseminated
Can have erythroderma >80% BSA
Nails can have oncholysis, pitting, oil spots
Koebnor phenomenon, Woronoff's ring
What are the risk factors/triggers for psoriasis?
Polygenic dispotion + environmental triggers
35-90% have family history
HLA-CW6 allele > 10x risk
PSORS1-9 susceptibility regions
How should suspected psoriasis be investigated?
Skin biopsy if atypical
What are possible differential diagnoses for psoriasis?
(Bowens disease, drug eruption, infection, secondary syphilis, contact dermatitis, extramammary Paget's)
What are some subtypes of psoriasis?
Chronic plaque psoriasis
How is psoriasis treated?
- emollients - cream vs ointments
- soap substitutes
- vitamin D3 analogues
- coal tar creams
- topical steroids with care
- salicylic acid
- crude coal tar
- UVB phototherapy (guttate)
- retinoids - acritretin
- immunosuppression - methotrexate, ciclosporin
- biologics - anti-TNF (etanercept), anti-interleukin (ustekinumab)
What management should be given in complications of psoriasis requiring hospital treatment?
Thick greasy ointment emollients
Monitoring - PASI, DLQI
What is the general prognosis for psoriasis?
Good with correct treatment
Men lose 3.5y on average
Women lose 4.4y
What is the pathophysiology of psoriasis?
Due to adaptive immune system
- T cells (epidermal CD8, dermal CD4 and 8)
Activation of dermal dendritic cells - present uncertain antigen to naive T cells in lymph nodes - differentiation into Th cells > psoriatic dermic and plaque formation
Cell cycle reduced from 28 days to 3-5 days