Psoriasis

Question 1

what is psoriasis?

Answer 1

inflammatory skin condition usually characterised by well-defined scaly plaques ⁷

Question 2

FH statistics?

some go on to develop?

Answer 2

1.3rd have FH

5% develop psoriatic arthritis

Question 3

presentation?

Answer 3

red scaly plaques that are often symmetrical

Question 4

what causes psoriasis?

Answer 4

overactive immune system

epidermal infiltration by activated T cells leading to increased epidermal cell proliferation and turnover

3-5 day cycle from 28day

Question 5

what is there excessive production in?

Answer 5

TH1 cytokines: TNFa

linked to flares

Question 6

histology in psoriasis? (5)

Answer 6

hyperkeratosis
neutrophils in stratum corner
hypogranulosis
psoriasiform
dilated dermal capillaries

Question 7

what is the most common form of psoriasis?

Answer 7

chronic plaque psoriasis

Question 8

Guttate psoriasis?

Answer 8

acute onset, post-viral
self-limiting
step infection
responds well to phototherapy

Question 9

palmo-plantar psoriasis?

Answer 9

skins on palms and soles of feet appear thick, scaly and red

Question 10

scalp psoriasis?

Answer 10

kyperkeratotic plaques on scalp

Question 11

nail psoriasis?

Answer 11

pitting and oncholysis

Question 12

flexural/inverse psoriasis?

Answer 12

shiny and lack of scale in armpits and flexes

Question 13

pustular psoriasis?

Answer 13

red tender patches with multiple yellow pustules on inspection

Question 14

erythrodermic psoriasis?

Answer 14

red man syndrome
after oral steroids
>90% body surface

admit: fluid balance, bloods & thick greasy ointment emollients

Question 15

differential diagnosis? (3)

Answer 15

seborrhoea dermatitis
lichen planus
mycosis fungoides (biopsy)

Question 16

initial treatment? (5)

Answer 16

emollients (creams/ointments)
vitamin D3 analogues
tar creams
topical steroids
salicylic acid

VETTS

Question 17

further treatment? (4)

Answer 17

UVB phototherapy
Acitretin
Methotrexate
Biologics