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Dermatology Diploma > Psoriasis > Flashcards

Flashcards in Psoriasis Deck (59)
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1

GENETICS

What % of new cases of psoriasis are familial?

40%

2

What the the single Major Histocompatability Complex (MHC) locus is the strongest susceptibility locus for psoriasis?

(Strongest gene)

PSORS1

3

What environmental factors affect the course of Psoratic disease?

  • Stress
  • Infection
  • Skin trauma
  • Drugs
  • Alcohol

 

4

What drugs are associated with worsening/developing psoriasis?

  • Beta Blockers
  • NSAIDs
  • Lithium
  • Anti-Malarials

 

5

What form of psoriasis has the strongest link with smoking?

Pustular psoriasis

6

What is the aetiology of psoriasis?

  • T-lymphocytes & Dendritic cells produce cytokines
  • These Cytokines stimulate keratinocytes
  • Keratinocytes proliferate and increase inflammatory cells to the skin
    • Epidermal Hyperplasia and inflammation occurs.

7

What are the peak decades of onset?

20-30yrs and 50-60yrs

8

What are the subtypes of Psoriasis?

  • Thin Plaque Psoriasis
  • Flexural Psoriasis
  • Pustular Psoriasis
  • Gutatte Psoriasis

9

What type of psoriasis is this?

Pustular Psoriasis

10

What type of psoriasis is this?

Guttate Psoriasis

11

What type of psoriasis is this?

Thin Plaque Psorasis

12

What is the commonest form of psorasis?

Plaque Psorasis

13

Where does plaque psoriasis most commonly appear?

  • Scalp - 80%
  • Elbows more than knees (75% vs 55%)
  • Legs more than arms (75% vs 55%)
  • Soles of the feet in 13%

14

If you notice psoriasis, what part of the body should you also examine.

The nails.

Look for Subungual Hyperkeratosis, Pitting, onycholysis.

15

What form of psoriasis is the 2nd most common form of psoriasis in adults & the most common in children?

Guttate Psoriasis

16

What is strongly linked to guttate psoriasis?

Streptococcal infection

17

What investigations should be done if you see guttate psorasis?

ASO Titres.

Check for sore throat.

18

What is the differential diagnosis for guttate psoriasis?

  • Pityriasis rosea
  • Secondary syphilis
  • Rarely: pityriasis lichenoides chronica

19

What is the management of guttate psoriasis?

UV light.

Topical therapies don't really work.

The plaques settle in a few weeks to a few months.

20

What type of psoriasis is this?

Flexural psoriasis

(AKA Inverse Psoriasis)

21

What type of psoriasis is this and how does it differ from cadidal nappy rash?

Napkin psoriasis

(There is clear demarcation here where as in candidal infection there are satellite lesions)

22

What type of psoriasis is this and what should you do as a GP?

Unstable psoriasis

  • Refer as a Dermatological emergency

23

What type of psoriasis is this?

Erythrodermic psoriasis

  • Differentials: Eczema, Drug Rection, Cutaneous T-Cell Lymphoma & Pityriasis rubra pilaris.
  • Dermatological Emergency
  • Biopsies are taken.

24

What type of psoriasis is this?

When does it develop?

How is it managed?

Palmar Pustular psoriasis

  • Middle age
  • Treat with topical therapies & Smoking cessation
  • If these fail consider Acitretin.

25

What type of psoriasis is this?

Generalised Pustular Psoriasis

  • Differntial Diagnosis: Acute Generalised Eruptive Pustulosis
  • Pustular psoriasis may arise when patients stop or reduce oral steroids.
  • Dermatological Emergency

26

What form of psoriasis is this?      

How is it treated?

Acrodermatitis Continua of Hallopeau

Usually treated with methotrexate

27

What other areas of the body should you check in psoriasis?

  • Scalp
  • Anogenital area
  • Fingers
  • Joints

28

What percentage of patients have anogenital psoriatic lesions?

How is it treated?

30-40%

  • Combination therapy with moderate strength steroids and antifungals. (Trimovate or Lotriderm) for intermittent periods.

29

What % of patients will have scalp psorasis?

80%

30

What is this form of psoriasis called?

Pityriasis Amianatacea

Large waxy adherent scales infiltrates and surrounds the base of a group of scalp hairs