scott psoriasis Flashcards
(24 cards)
psoriasis
chronic autoimmune inflammatory skin disorder
t-lymphocyte mediated disease
what does psoriasis look like
thickened, red patches covered by silvery white scales
why are there so many white patches
rapid skin growth 7x faster than normal
who is affected by this
2% of US pop
onsety usually prior to 40 yo
usually a series of exacerbations/remissions
most common places for psoraiasis
knees and elbows
classic psoriasis lesion
scab like or scale like on top of skin
moderate psoriasis
5-10% BSA
80% of pts have mild-mod
severe
> 10% BSA
20% OF pts have severe disease
triggers
stress
environment (cold)
injury
infection
smoking
drugs
diet
goals of therapy
decrease symptoms
decrease % of BSA affected
improve QOL
reduce inflammation and slow down rapid skin cell division
ashieve clearing of lesions
PROLONG PERIODS BW EXACERBATIONS
TX-GENERAL MEASURES
Sun, baths, emollients, keratolytics (salicylic acid)
general approach
topical therapy
UV phototherapy
systemic therapy
biologic therapy
IF YES TO PSORIATIC ARTHRITIS:
immediately use a biologic
if NO to psoraitic arthritis:
ask if they have limited disease or extensive disease
if they have lIMITED DISEASE:
use topicals/targeted phototherapy
(IF THERE IS LACK OF EFFECT, USE EXTENSIVE DISEASE TX)
if they have EXTENSIVE DISEASE:
use UVB/PUVA, systemic tx, or biologic.
topical therapy
more effective when used to treat localized plaques psoriasis covering <20% of BSA
70% of patients recieves only this
Emollients
1st line
used for all patients
Corticosteroids ***
1st line
high potency oint preferred for scaly lesions
calipotriene
1st line
inhibit proliferation of lesions
CORT+ vit D
1st line
calcipotriene and betamethasone
ointment and topical suspension
cort+tazarotene
1st line
calcineurin inhibitor
1st line
for areas not suitable for corts
face and flexures
