Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y4 Lecture Day III > Psoriasis > Flashcards

Psoriasis Flashcards

(40 cards)

Start Studying
1
Q

Pathophysiology of psoriasis

A
  • multifactorial and not yet fully understood
  • genetic: associated HLA-B13, -B17, and -Cw6 strong concordance (70%) in identical twins
  • immunological: abnormal T cell activity stimulates keratinocyte proliferation. This may be mediated by a novel group of T helper cells producing IL-17, designated Th17
  • environmental: psoriasis may be worsened (e.g. Skin trauma, stress), triggered (e.g. Streptococcal infection) or improved (e.g. Sunlight) by environmental factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the subtypes of psoriasis?

A
  • plaque psoriasis: the most common sub-type resulting in the typical well-demarcated red, scaly patches affecting the extensor surfaces, sacrum and scalp
  • flexural psoriasis: in contrast to plaque psoriasis the skin is smooth
  • guttate psoriasis: transient psoriatic rash frequently triggered by a streptococcal infection. Multiple red, teardrop lesions appear on the body
  • pustular psoriasis: commonly occurs on the palms and soles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of psoriasis

A
  • red, scaly patches on the skin
  • nail signs: pitting, onycholysis
  • arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complications of psoriasis

A
  • psoriatic arthropathy (around 10%)
  • increased incidence of metabolic syndrome
  • increased incidence of cardiovascular disease
  • increased incidence of venous thromboembolism
  • psychological distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Factors that may exacerbate psoriasis

A
  • trauma
  • alcohol
  • drugs: beta-blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
  • withdrawal of systemic steroids
  • Streptococcal infection may trigger guttate psoriasis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drugs may exacerbate psoriasis?

A
  • beta-blockers
  • lithium
  • antimalarials (chloroquine and hydroxychloroquine)
  • NSAIDs and ACE inhibitors
  • infliximab
  • withdrawal of steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What score to use as a screening tool for psoriasis?

A

Use the PEST score as a screening tool for psoriatic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What not to forget about during Hx taking of psoriasis?

A

Don’t forget the other organ systems – particularly joints and cardiovascular risk

i. e. Psoriasis is more than just a skin:
- Increased risk of IBD
- Psoriatic arthritis
- Metabolic syndrome
- Mental health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why there is a possible metabolic syndrome in psoriasis?

A

Metabolic syndrome thought to occur due to:

  • increase total body inflammation → increased levels of circulating cytokines including TNF alpha
  • Defined as increased waist circumference, TGs, low HDL, high BP, high BMs
  • They are in a prothrombotic, proinflammatory state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Differentials for rashes that follow sore-throat

A
  • Guttate psoriasis
  • Small vessel vasculitis
  • EBV / Glandular fever
  • EBV treated with Ampicillin
  • Drug rash
  • Pityriasis rosea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dangers of drinking alcohol in a patient suffering from psoriasis

A

Alcohol:

  • makes psoriasis worse
  • contributes to liver abnormalities in patients already at risk of NAFLD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sort throat then rash - what Ix to ask about next?

A

ASOT and monospot

*ASOT Antistreptolysin O Titer. A blood test that looks for antibodies to the streptococcus A bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Patterns of psoriasis

A
  • Chronic plaque
  • Guttate
  • Palmar plantar and palmar - plantar pustulosis
  • Erythroderma
  • Pustular
  • Flexural
  • Scalp
  • Nails
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What to use to document the severity of psoriasis?

A

(area, erythema, scaling and induration)

Psoriasis Area and Severity Index (PASI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to describe psoriatic lesion?

A

Well demarcated plaques on the extensors, thick silvery scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common sites of psoriatic plaques

A
  • extensors
  • scalp
  • gluteal cleft
  • genitalia
  • intertriginous areas /obszary miedzyzebowe/
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Difference between eczema and psoriasis (in terms of lesions)

Study These Flashcards
A

Eczema is not so well defined and the scale is thinner

18
Q

Buzzwords: Rain droplets’ + Strep throat

What’s the diagnosis?

Study These Flashcards
A

Rain droplets’ + Strep throat = Guttate Psoriasis

19
Q

What’s guttate psoriasis?

Study These Flashcards
A

Guttate psoriasis:

  • more common in children and adolescents
  • may be precipitated by a streptococcal infection 2-4 weeks prior to the lesions appearing
  • *Features**
  • tear drop papules on the trunk and limbs
20
Q

Mangement of guttate psoriasis

Study These Flashcards
A
  • most cases resolve spontaneously within 2-3 months
  • topical agents as per psoriasis
  • UVB phototherapy
  • tonsillectomy may be necessary with recurrent episodes
21
Q

The differential diagnosis for Guttate psoriasis

Study These Flashcards
A

Pityriasis rosea – presents with a herald patch, improves spontaneously

22
Q

How to differentiate between Guttate psoriasis and Pityriasis Rosea?

23
Q

What’s that?

Study These Flashcards
A

Palmar - plantar pustulosis → pattern of psoriasis

  • Sheets of tense sterile blisters
  • Resolve leaving yellow/brown macules
  • Usually current smokers
24
Q

Causes of erythroderma

Study These Flashcards
A
  • Idiopathic
  • Drugs
  • Eczema
  • Psoriasis
  • Cutaneous lymphoma
25
What's that?
**Erythrodermic psoriasis** * may result from progression of chronic disease to an exfoliative phase with plaques covering most of the body. Associated with mild systemic upset * more serious form is an acute deterioration. This may be triggered by a variety of factors such as withdrawal of systemic steroids. Patients need to be admitted to hospital for management
26
Define erythroderma
**Erythroderma** is a term used when more than 95% of the skin is involved in a rash of any kind
27
What's that?
Pustular and flexural patterns of psoriasis * Malaise and fever * Erythema studded with sterile pustules * Initally in intertiginous areas, but quickly progresses * Triggers; weaning oral steroids, infection, hypocalcaemia, pregnancy * Can be difficult to diagnose as scale is not prominent * Shiny, only slightly raised plaques in flexures, often misdiagnosed as fungal, but it is symmettical * Sebopsoriasis is scaling around the eyebrows, behind ears, ear canals
28
Nail changes in psoriasis
Psoriatic nails (50% fingernail, 35% toenail) * Matrix: Pitting, leuconychia * Bed: Oil spots, onycholysis, subungal hyperkeratosis, splinter haemorrhage \*More frequent with coexistant psoriatic arthritis
29
Types of psoriatic arthropathy
* **rheumatoid-like polyarthritis**: (30-40%, most common type) * **asymmetrical oligoarthritis:** typically affects hands and feet (20-30%) * **sacroilitis** * **DIP joint disease** (10%) * **arthritis mutilans** (severe deformity fingers/hand, 'telescoping fingers')
30
What's shows up first (timewise) psoriasis or psoriatic arthropathy?
Usually psoriasis first → then arthropathy (10 years gap)
31
Features of psoriatic arthropathy
* Asymmetrical oligoarthropathy ≤4 joints * Symmetrical polyarthropathy ≥5 joints * DIP joint involvement * Axial/spondyloarthropathy * Arthritis mutilans – destructive with bone resorption and osteolysis
32
How psoriatic arthropathy should be managed?
* should be managed by a rheumatologist * treat as rheumatoid arthritis but better prognosis
33
General steps in the treatment of psoriasis
* Topicals * Light treatment * Systemic immunosuppression * Biologics
34
What are the options used in the topical treatment of psoriasis?
* Topical corticosteroids * Vitamin D3 analogues * Emollients * Coal tar * Dirthranol
35
Topical steroids + vit D preparations used in psoriasis
36
Coal Tar preparations used in psoriasis
37
***Dithranol*** preparations and use in psoriasis
38
Light treatment in psoriasis
39
Immunosuppressive treatments and SEs in psoriasis
_Immunosuppression:_ -Increased risk of infection and cancers (particularly skin cancers) ***Ciclosporin*** * Renal function and blood pressure ***Methotrexate*** * Liver function, alcohol intake, nausea * ***Hydroxycarbamide*** Less effective * ***Fumaric acid esters*** Flushing, GI upset, Lymphopenia, PML * ***Acitretin*** Dry lips and eyes, triglyceride levels
40
Biologics in psoriasis - when to use - what to use (names)

Y4 Lecture Day III (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions