Psoriasis Flashcards
(7 cards)
What is psoriasis?
Chronic, genetically determined, immune-mediated, inflammatory skin condition, usually characterized by typical well defined, scaly, plaques.
It can also involve nails, hair and joints
What are the features of psoriasis?
Red scaly plaques
Often symmetrical distribution
What are the causes of psoriasis?
Overactivity of the immune system
Excessive production of TH1 Cytokines inc TNF-alpha
Vascular proliferation (erythema), increased cell turnover (plaques and scaling)
Genetics Environmental Infection Strep, Candida Drugs Lithium, Beta-blockers, NSAIDS, Steroid withdrawal Trauma – Koebner phenomenon (spread with trauma) Sunlight
What are eight types of psoriasis?
Chronic plaque psoriasis-most common type
Guttatte psoriasis-commonly post viral and self limiting
Palmar-plantar psoriasis
Scalp psoriasis
Nail psoriasis- get onycholysis and pitting
Flexural/inverse psoriasis
Pustular psoriasis
Erythrodermic psoriasis
What are initial treatments for psoriasis?
Emollients Creams vs. Ointments Vitamin D3 analogues (calcipotriol) +/- Top steroids - Inhibits epidermal proliferation Tar creams Topical steroids – fleuxural / genital area Salicylic acid ( Keratolytic) Dithranol Anthralin
What treatments can be used when more commonly used ones have failed?
UVB Phototherapy
Acitretin ( Teratogenic, Impairment of LFTs/ Lipids)
Methotrexate ( Also for Joint/ Nail involvement, Improvement within 2- 3 months)
Cyclosporin (Risk of renal impairement/ Cancer)
Inpatient Tar : Crude coal tar in zinc ointment
Biologics
What other conditions is psoriasis associated with?
Associated with cardiovascular disease, arthritis, smoking, alcohol, the metabolic syndrome, lymphoma, depression, suicide and possibly melanoma and non-melanoma skin cancers.
