Psoriasis

Question 1

What is psoriasis?

Answer 1

Chronic, genetically determined, immune-mediated inflammatory skin condition that is usually characterised by typical, well defined scaly plaques

Question 2

What is the epidemiology of psoriasis?

Answer 2

Peak incidences in 20’s and 50’s
Family history
Uncommon in Far East population, native Americans and west Africans

Question 3

What causes psoriasis?

Answer 3

An over activity of the immune system resulting in over production of TH1 cytokines

Question 4

What histological characteristics are associated with psoriasis?

Answer 4

Hyperkeratosis
Neutrophils in stratum corneum 
Hypogranulosis 
Psoriaform hyperplasia 
Dilated dermal capillaries
Perivascular lymphohistiocytic infiltrate

Question 5

What are the eight subtypes of psoriasis?

Answer 5

Chronic plaque psoriasis 
Guttate psoriasis 
Palmo-plantar psoriasis 
Scalp psoriasis 
Nail psoriasis 
Flexural/inverse psoriasis 
Pustular psoriasis
Erythrodermic psoriasis

Question 6

What are the clinical features of nail psoriasis?

Answer 6

Pitting of the nails

Onycholysis

Question 7

Which subtype of psoriasis generally doesn’t have scale?

Answer 7

Flexural/inverse psoriasis

Question 8

Which subtype of psoriasis requires in-patient treatment?

Answer 8

Erythrodermic psoriasis

Question 9

What initial treatments can be given for psoriasis?

Answer 9

Emollients
Tar creams 
Topical steroids
Vitamin D3 analogues 
Salicylic acid
Dithranol
Anthralin

Question 10

What second line treatments can be given for psoriasis?

Answer 10

UVB phototherapy 
Acitretin 
Methotrexate
Cyclosporin
Inpatient tar 
Biologics

Question 11

What treatment is necessary for erythrodermic psoriasis?

Answer 11

Admit patient
Fluid balance
Bloods/ IV access
Thick emollient