Psoriasis

Question 1

What % of the population are affected by psoriasis?

Answer 1

2%

Question 2

M:F?

Answer 2

1:1

Question 3

Does psoriasis cause scaring?

Answer 3

No but it can cause temporary discolouration

Question 4

Is psoriasis generally predictable?

Answer 4

Generally not (although it can have triggers)

Question 5

Can psoriasis affect anything other than skin?

Answer 5

Yes - nails and joints as well

Question 6

What condition can be associated with ~30% of moderate to severe psoriasis?

Answer 6

Psoriatic arthritis

Question 7

What factors influence psoriasis?

Answer 7

Genetic and environmental

Question 8

Is there a familial connection in psoriasis?

Answer 8

Yes

Question 9

What does psoriatic skin look like?

Answer 9

Red and scaly

Question 10

What is the underlying pathogenesis of psoriasis?

Answer 10

Increased rate of turnover of skin cells (from about 3-4 weeks to 3-4 days)

Question 11

What are some common triggers?

Answer 11

Infections
Stress
Alcohol
Smoking
Certain medications

Question 12

What medications can trigger psoriasis?

Answer 12

Beta blockers
Lithium
Anti-malarials

Question 13

What can happen on the hands and feet in psoriasis? Why?

Answer 13

Fissures can form as there is thickened skin there which cracks more due to the increased turnover of cells

Question 14

What is the technical term for psoriatic skin changes?

Answer 14

Plaques

Question 15

How many patterns of psoriasis are recognised?

Answer 15

4

Question 16

What are the 4 types of psoriasis patterns?

Answer 16

1. Chronic plaque
2. Guttate
3. Palmoplantar
4. Pustular

Question 17

What is the most common pattern of psoriasis?

Answer 17

Chronic plaque psoriasis

Question 18

How does chronic plaque psoriasis appear?

Answer 18

Plaques present on the knees, elbows, trunk and scalp most commonly

Question 19

What is guttate psoriasis?

Answer 19

Small plaques over trunk and limbs usually precipitated by streptococcus infection

Question 20

Where does palmoplantar psoriasis affect?

Answer 20

The hands and feet

Question 21

Where does pustular psoriasis affect?

Answer 21

Trunk and limbs

Question 22

How is pustular psoriasis different?

Answer 22

It is rare, the plaques are studded with tiny pus spots

Question 23

What are the features of nail psoriasis? (4)

Answer 23

• Nail surface pitting
• Pink nail bed discolouration
• Nail thickening
• Nail plate and bed separation

Question 24

Who diagnoses psoriasis?

Answer 24

Rheumatologist usually, but GP and dermatologist contribute

Question 25

What is the PGA?

Answer 25

Physician global assessment

Question 26

What does the PGA assess?

Answer 26

Overall impression of severity of psoriasis

Question 27

What can be used to screen for psoriasis?

Answer 27

PEST score

Question 28

What does PEST stand for?

Answer 28

Psoriasis Epidemiology Screening Tool

Question 29

Can psoriasis be cured?

Answer 29

Nope

Question 30

How can psoriasis be treated initially?

Answer 30

Topical treatments such as creams, ointments, pastes and lotions Emollients Corticosteroids Coal tar preparations Vitamin D analogues

Question 31

How does phototherapy work?

Answer 31

Controlled UV light is used to clear psoriasis

Question 32

What tablets can be used for systemic treatment?

Answer 32

Aciretin Ciclosporin Methotrexate and other immunosuppressants Biological agents

Question 33

What can be injected to treat psoriasis?

Answer 33

Monoclonal antibodies such as adalimumab and infliximab

Question 34

What are the 2 varitions of chronic plaque psoriasis?

Answer 34

Scalp psoriasis and flexural psoriasis

Question 35

What does pustular psoriasis require?

Answer 35

Urgent care by a dermatologist

Question 36

When does guttate psoriasis usually occur?

Answer 36

After a sore throat

Question 37

Which disorders are associated with psoriasis?

Answer 37

- Psoriatic arthritis - IBD - Uveitis - Coeliac disease - Metabolic syndrome

Question 38

What is the typical treatment regimen for classic psoriasis?

Answer 38

1. Vit D analogues +/- topical steroids + tar/salicylic acid +/- UVB 2. Retinoids, PUVA, UVB, immunosuppressants 3. Dithranol

Question 39

When is referral indicated for psoriasis?

Answer 39

If more than 10% of body surface area is affected Not responding to topical Rx Childhood psoriasis Major impact on psychological health

Question 40

What are the complications associated with psoriasis?

Answer 40

Mental health disorders | Associated reduced rate of employment

Question 41

What factors are assoiated with poorer prognosis for psoriasis?

Answer 41

Strong FHx Early age of onset Over-use of steroids

Question 42

What kind of autoimmune condition is psoriasis?

Answer 42

T cell-mediated