Psoriasis Flashcards
Epidemiology of Psoriasis
2% of Caucasians, peaks in 20s and 50s, M=F, 30% have FHx
Pathology of Psoriasis
Type 4 hypersensitivity reaction, epidermal proliferation, T-cell driven inflammatory infiltration
Histology of Psoriasis
Acanthosis - thickening of epidermis, parakeratosis - nuclei in stratum corneum, Munro’s microabscesses - neutrophils
Triggers of Psoriasis
Stress, infection - esp. streps, skin trauma - Kobner phenomenon, drugs - beta blockers, lithium, anti-malarials, alcohol, smoking
Psoriatic plaque description
symmetrical well-defined red plaques w/ silvery scale, extensors - elbows/knees, flexures (no scale) - axillae/groins/submammary, scalp, behind ears, navel sacrum
Psoriatic nail changes
in 50% of pt, pitting, onycholysis, subungual hyperkeratosis
Guttate psoriasis description
drop-like salmon-pink papules w/ fine scale, mainly on trunk, occurs in children associated w/ strep infection
Pustular psoriasis description
sterlie pustules, may be localised to palms and soles
Erythroderma and generalised pustular psoriasis description
generalised exfoliative dermatitis, severe systemic upset - fever, increased WCC, dehydration; may be triggered by rapid steroid withdrawal
DDx of Psoriasis
Eczema, tinea - asymmetrical, seborrhoeic dermatitis
Mx of psoriasis
Education -> soap substitutes/emolllients -> topical therapy -> UV phototherapy -> non-biologicals -> biologicals
Education Mx in Psoriasis
Avoid triggers
Soap substitutes in Psoriasis
aqueous cream, dermol cream, epaderm ointment
Emollients in Psoriasis
epaderm, dermol, diprobase
Topical therapy in Psoriasis
vitamin D3 analogue e.g. calcipotriol, steroids e.g. betamethasone, tar - mainly reserved for in-pt use, dithranol, retinoids e.g. tazarotene
