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Dermatology > Psoriasis and Acne > Flashcards

Psoriasis and Acne Flashcards

1
Q

What is the most common autoimmune disease in the U.S?

A

Psoriasis

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2
Q

What happens in psoriasis

A

T-cells are stimulated by an undefined antigen by an undefined antigen presenting cell. These T cells release pro-inflammatory cytokines such as TNF and IFN that induce keratinocyte and endothelial cell proliferation

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3
Q

These three psoriasis drugs have the same MOA. What are they and what is the mechanism?

A

Adalimumab, Etanercept, and Infliximab

They are all TNF Alpha blockers

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4
Q

More specifically, what is adalimumab?

A

It is a monoclonal antibody for TNF-Alpha

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5
Q

What is Etanercept?

A

It is a receptor antibody fusion protein for TNF- alpha

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6
Q

What is Infliximab?

A

It is a chimeric monoclonal antibody for TNF-alpha

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7
Q

It is important to note that all of these TNF-alpha blockers can be used against other autoimmune diseases such as arthritis, spendylitis, crohn’s,etc…

A

ok

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8
Q

What are the Black Box Warnings for the TNF-alpha blockers

A

May predispose to infections (fungal, mycobacterial/viral) , neoplasia, and tuberculosis

This reflects their immunosuppresive character.

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9
Q

Infliximab can cause adverse effects like?

A

Heart Failure, Murine protein hypersensitivity

Inflicts heart failure and murine protein hypersensitivity

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10
Q

Etanercept

A

Etaner-sepsis…absolutely contraindicated w/ sepsis

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11
Q

What is Ustekinumab

A

It binds the p40 subunit used for Interleukin 12 and Interleukin 23 stimulation. This helps them suppress Th12 and Th17 which are both pro-inflammatory cells.

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12
Q

What are the potential side-effects of Ustekinumab?

A

Potential for infection, neoplasms

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13
Q

What are the contraindications for ustekinumab>

A

Live vaccines, test for latent TB before giving. Some anaphylactic responses have been reported.

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14
Q

Retinoids and Retinoic acid =

A

Vitamin A

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15
Q

What is Vitamin A usually responsible for?

A

bone growth, testicular development and function, ovarian function, maintenance of mucosal and epithelial surfaces

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16
Q

What are the two Retinoid drugs?

A

acetretin and tazarotene

17
Q

How does Retinoic acid help treat acne

A

It increases cell turnover and mitosis. Expulsion of active comedones (white heads and black heads) and prevent new comedones from forming through sloughing and expulsion of horny cells from the follicle.

18
Q

Drugs that target the Retinoid A receptors are?

A

Tretinoin (ATRA)/ Isotretinoin, Adalpene, Tazarotene

19
Q

Targeting RAR predominantly affects?

A

Differentiation and proliferation

20
Q

Targeting RX

A

Induces apoptosis

21
Q

RAR drugs are used to treat acne/psoriasis whereas RXR drugs are used more frequently in the treatment of Kaposi’s Sarcoma and mycosis fungoides

A

truth

22
Q

Systemic toxicity of Retinoids

A

Pretty much Vitamin A intoxication.
Nosebleed, dry skin, hair loss, poor night vision.

Retinoids are Teratogenes

Retinoids induce hyperlipidemia.

23
Q

Prior to retinoid therapy, what should be tested

A

Do a pregnancy test, test lipids, and do a CBC

24
Q

Monitor Isotretinoin pts for what>

A

suicidal thoughts

25
Q

Topical retinoids used for?

A

acne and photoaging correction

26
Q

How do topical retinoids work against acne

A

Correct follicular keratinization, reduce P. acnes counts, and reduce inflammation

27
Q

How do topical retinoids provid relief of photoaging

A

inhibit matrix metalloproteinases in response ot UV radiation, Induce epidermal hyperplasia in atrophic skin and reduce keratinocyte atypia,

28
Q

adverse effects of topical retinoids

A

erythema, desquamation, burning and stinging

29
Q

Calcipotriene can induce what>

A

Hypercalcemia and hypercalciurua

Also greater susceptibility to UV damage

30
Q

Calcitriol

A

Hormonally active VitD3. Better tolerated in sensitive skin areas

31
Q

Look at sheet for benzoyl peroxide , steroids, and salicylic acid

A

ok

32
Q

Topical glucocorticoid potency is measured by>

A

ability to produce cutaneous blanching.

Classified as mild-moderate-potent-and very potent

Dermatology (17 decks)

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