Troublesome rash

Question 1

Psoriatic Nail changes

Answer 1

Periungal erythema
Pitting
Subungal hyperkeratosis
Onycholysis

Question 2

Psoriasis

Answer 2

Chronic plaque
Erythrodermic - red, hot painful, no longer clearly defined plaques, hypotensive, admit for tx
Generalised pustular - development of pustules within the plaques, rare, EMERGENCY - REQUIRE ADMISSION, trigger is withdrawal of superpotent topical steroids / systemic steroid
Guttate
Flexural

Question 3

Underlying genetics

Answer 3

Type 1 (75%) - first present < 40, genetic linkage with HLA-CW6

Type 2 (25%) - first present 55-60, no association with HLA-CW6

Question 4

Screening tools

Answer 4

Psoriasis Area Severity Index

Dermatology of Life Index

Question 5

When to stop tx

Answer 5

Continue until plaques not palpable
Continue emollients
Review in 4-6 weeks
Make sure pt knows how to manage and have management plan