psoriasis

Question 1

drugs which can cause

Answer 1

beta blockers
lithium
antimalarials

Question 2

basis of pathogenesis

Answer 2

hyperteratosis

parakeratosise

Question 3

parakeratosis

Answer 3

retention of nucleu in corneocytes in the stratum corneum
due to increased proliferation reducing the time for migration and differentiation
associasted with the thinning or loss of the granular layer

Question 4

hyperkeratosis

Answer 4

thickening of the keratin layer

Question 5

other more unusual clinical changes in psoriasis

Answer 5

dilation and proliferaition of dermal blood vessels- become torturous
accumulation and inflammation of immune cells especially t cells in the dermis and epidermis

Question 6

what is seen histologically in psoriasis

Answer 6

thinning of the stratum corneum
parakeratosis- absence of granular layer
prickle cell layer is thickened
lots of neutrophils

Question 7

munro absesses

Answer 7

collection of neutrophils in the strateum corneum of the epidermis due to infiltration of neutrophils

Question 8

most common type of psoriasis

Answer 8

chronic plaque

Question 9

rash in chronic plaque

Answer 9

mildly itchy palpable scaly erythematous plaques

plaques often symmetrical and scale may be silvery

Question 10

auspitz sign

Answer 10

removing scale in chronic plaque causes pinpoint bleeding

Question 11

sign in chronic plaque

Answer 11

auspitz sign

Question 12

where is chronic plaque seen

Answer 12

preferentially develops on the extensor aspects of knees elbows sacrum and scalp

Question 13

psoriasis of the scalp

Answer 13

most commonly seen at the posterior aspect of the scaly

extend below the hairline and associated with itch and no interruption to hair growth

Question 14

koebner phenomon

Answer 14

plaques similar to chronic plaque develop 2-6 weeks after trauma has occurred
trauma can be physical subburn or another skin condition

Question 15

guttate psoriasis

Answer 15

seen in younger patients- 15 to 25

onset 7 to 10 days after an infection- strep throat

Question 16

rash in guttate psoriasis

Answer 16

fine pear drop in shape
on trunk arms and legs
well demarcated scaly erythematous plaques

Question 17

flexural psoriasis

Answer 17

axilla
under breast
groin
common in older

Question 18

rash in flexural psoriaisis

Answer 18

erythmatos glazed well demarcated plaques with or without scale

Question 19

erythrodermic psoriasis

Answer 19

can develop de novo or in patients who have a deteriorating psoriasis
onset can be preticipated in a patient taken of potent steroids
quite serious can lead to complete failure of the skin

Question 20

rahs in erythrodermic psoriasis

Answer 20

well demarcated plaques with absent scale or very fine scaling with confluent full body erythema

Question 21

generalised pustular psoriasis

Answer 21

the skin is often painful and there is associated fever and malaise

Question 22

rash in generalised pustular psoriasis

Answer 22

sterile pustules within plaques of psoriasis and widespread erythema

Question 23

palmo plantar pustulosis

Answer 23

now considered a distinct condition that is related to psoriasis
typically women over 50
strong association with smoking

Question 24

rash in palmo plantar pustolosis

Answer 24

multiple yellow pustules that develop into brown macules that then develop scale

Question 25

nail problems in psoriasis

Answer 25

oncholysis pitting dystrophy subungal hyperkeratosis

Question 26

oncholysis

Answer 26

seperastion of the nail from the nail bed

Question 27

subungal hyperkeratosis

Answer 27

extreme reproduction of skin cells | accumulate between nail and nail bed

Question 28

wht decreases life expectancy in those with psoriasis

Answer 28

increased cardiovascular risk 4 yr shorter life expectancy also increased risk of lymphoma

Question 29

example of vitamin d analogue

Answer 29

calciptriol | calcitriol

Question 30

dithranol

Answer 30

used in short contact reginmes for stable chronic plaque disease as it burns and stain normal skin

Question 31

coal tar

Answer 31

only used on in patients due to its smell and mess

Question 32

salicylate

Answer 32

used to break down particularly hyperkeratotic skin

Question 33

side effects of phototherapy

Answer 33

subburn conjunctivitis excacerbation of HSV

Question 34

treatment for mild to moderate psoriasis

Answer 34

1st topical corticosteroids and / or topical vitamin d analogue more effect when used as a combo vit d analogue counteracts side effects of the steroids

Question 35

example of the topical steroid used

Answer 35

hydrocortisone triamcinolone flucinodone clobetanol

Question 36

example of topical vitamin d analogue

Answer 36

calcipotriol topical

Question 37

treatment of moderate to severe psoriasis

Answer 37

1st- phototherapy 2nd - methotrexate bioagenet retinol

Question 38

treatment of guttate psoriasis

Answer 38

1st- phototherapy 2nd0 methotrexate/ oral retinoid 3rd - ciclosporin

Question 39

treatment of pustular psoriasis

Answer 39

1st- oral retinoid | 2nd- puva