Psoriasis

Question 1

What % of the population have psoriasis

Answer 1

2%

Question 2

What are the 2 ages groups that get psoriasis?

Answer 2

Late teens

50s

Question 3

Aetiology psoriasis (3)

Answer 3

FHx
Enviro
HLA-CW6

Question 4

What is the most common type of psoriasis

Answer 4

Chronic plaque psoriasis

Question 5

Features chronic plaque psoriasis (7)

Answer 5

Salmon pink patches /plaques
Well demarcated 
Silver scale
Extensors 
Symmetrical 
Nail changes

Question 6

Nail changes seen in psoriasis (3)

Answer 6

Pitting
Onycholysis
Subungal hyperkeratosis

Question 7

DDx flexural psoriasis (3)

Answer 7

Eczema
Heat rash
Fungal infection

Question 8

Areas affected by flexural psoriasis (5)

Answer 8

Armpits 
Penis 
Umbilicus 
Under breasts 
Natal cleft

Question 9

Who gets guttate psoriasis

Answer 9

Children/adolescents

Question 10

Cause guttate psoriasis

Answer 10

Acute strep infection

Question 11

Appearance guttate psoriasis

Answer 11

Rain drop lesions

In linear configuration

Question 12

What may guttate psoriasis precede?

Answer 12

Chronic plaque psoriasis

Question 13

What % body SA is affected in erythrodermic psoriasis?

Answer 13

> 90%

Question 14

Who gets palmoplantar pustular psoriasis

Answer 14

F
ADults
who are smokers

Question 15

What precipitates generalised pustular psoriasis

Answer 15

Steroid withdrawal

Question 16

Appearance generalised pustular psoriasis

Answer 16

sheets pustules

+ background erythema

Question 17

What is the Koebner phenomenon

Answer 17

Tendency for a skin condition to occur within scars or sites of trauma

Question 18

What area of the body is hardest to get rid of psoriasis from?

Answer 18

Legs

Question 19

Aggravating factors psoriasis (7)

Answer 19

Strep 
Medication
Stress 
Alcohol 
Cigarettes 
Trauma 
Friction

Question 20

What medications can aggravate psoriasis?

Answer 20

Beta blockers
Lithium
Anti-malarials

Question 21

At what DLQI score would you consider psychological intervention?

Answer 21

> 10

Question 22

What score determines the serverity of psoriasis?

Answer 22

PASI

Question 23

How is the PASI score calculated?

Answer 23

Redness
Thickness
Scaling

Question 24

A PASI score of what would indicate systemic treatment should be commenced?

Answer 24

> 10

Question 25

1st line Tx psoriasis

Answer 25

``` Emollients e.g. E45 Calcipotriol TO CCS e.g. eumovate Keratoyltics - salicylic acid Coal tar Dithranol ```

Question 26

1st line Tx thick plaques

Answer 26

Salicylic acid | Dithranol

Question 27

1st line Tx guttate psoriasis (4)

Answer 27

Emollients Coal tar Clcipotriol dovonex TL01 UVB

Question 28

Specific Tx - scalp psoriasis

Answer 28

Cocois Coal tar shampoo TO CCS scalp application

Question 29

Specific Tx - face psoriasis

Answer 29

Mild TO CCS - 1% HC

Question 30

Specific Tx - flexural psoriasis

Answer 30

Calcitriol ointment

Question 31

SE - phototherapy (3)

Answer 31

Erythema/pruritis Nausea Skin cancer

Question 32

Mx Eryhthrodermic psoriasis, generalised pustular psoriasis

Answer 32

Admit Supportive Liberal emollients/potent TO steroids

Question 33

3rd line Tx psoriasis (3)

Answer 33

Methotrexate Ciclosporin Acitretin

Question 34

Methotrexate SE

Answer 34

``` Teratogenicity Nausea GI upset Liver fibrosis Marrow suppression ```

Question 35

What MUST be monitored inf on methotrexate

Answer 35

LFT | FBC

Question 36

SE ciclosporin

Answer 36

``` HTN Nephrotoxicity Carcinogenesis Gym hypertrophy Tingling peripheries ```

Question 37

What must be monitored if on ciclosporin

Answer 37

BP | U+E

Question 38

How long is acitretin teratogenic for?

Answer 38

2 years

Question 39

SE acitretin (4)

Answer 39

Dry skin Dry lips Hyperlipidaemia Hepatotoxicity

Question 40

What must be monitored if on acitretin

Answer 40

Fasting lipids | LFTs