Psoriasis

Question 1

genetic cause of psoriasis

Answer 1

TH1 and Th17 stimulating keratinocyte proliferation, AMP release and neutrophil-attracting chemokines)

Question 2

environmental causes

Answer 2

stress
drugs
infection

Question 3

presentation

Answer 3

chronic, demarcated, scaly, erythematous plaques
silver scale
extensor surfaces
symmetrical distribution
nail changes

Question 4

nail changes in psoriasis

Answer 4

onycholysis (lifting of nail from the nailbed)
nail pitting
dystrophy
subungual hyperkeratosis

Question 5

what is Koebner’s phenomenon

Answer 5

psoriasis develops in an area of previous trauma

Question 6

what is Auspitz sign?

Answer 6

removal of surface scale reveals tiny bleeding points

Question 7

systemic disease presentations

Answer 7

arthritis
metabolic syndromes
Crohn’s
cancer

Question 8

types of psoriasis

Answer 8

vulgaris
guttate (everywhere)
palmoplantar pustular
erythrodermic

Question 9

management of psoriasis

Answer 9

vitamin D analogues
coal tar
dithranol
steroid ointment (use in combination)
emollients
phototherapy
systemic treatments e.g. methotrexate

Question 10

examples of vitamin D analogues

Answer 10

calcipotriol (localised plaques)

calcitriol (flexures)

Question 11

when should dithranol be used?

Answer 11

few localised plaques

short contact

Question 12

how can coal tar be used?

Answer 12

use anywhere with no limit to amount