Week 1 - Tony Sampson Flashcards
What would you observe in the skin layers with chronic inflammation?
- Fibrosis
- Hyperkeratosis and parakeratosis - thickened corneum
- Giant cells
- Infiltration of macrophages and leukocytes into the epidermis from the dermis
- Proliferation of langerhan cells in the epidermis
What causes psoriasis?
Genetic predisposition
Abnormal expression of one or more of the psoriasis susceptibility genes leads to infiltration of psoriatic plaques by cytotoxic lymphocytes, that produce proinflammatory cytokines like TNF-a, IFN-g or interleukin-2/12. These stimulate keratinocyte proliferation. They are more actively dividing epidermal cells, with an increased rate of production and transmission through the skin - 1 week, instead of one month.
Describe the psoriatic skin lesions
Inflamed, rapidly dividing areas of cells that show as itchy, flaky layers of dead keratinocytes
What are some key things to ask in a history when presenting with a skin disorder?
- Mental health
- Allergies
- Changes in body care/products
- Medications
- Family history
What are: nodules macules patches papules Bullae Wheals
Nodule - raised lesion over 1-1.5cm Macule - flat lesion under 1.5cm Patch - flat lesion over 1.5cm Papule - raised lesion under 1-1.5cm Bullae - fluid filled lesion Wheal - individual lesion in urticaria Plaque - thick scale
What do the terms ... mean in terms of distribution of lesions? generalized localized dermatomal flexural extensor acral photosensitive distribution unilateral perioral retro-articular
generalized - all over localized - one specific area dermatomal - follows line of dermatome flexural - in skin fold extensor - on the posterior surface acral - on the head, hands and feet photosensitive distribution - on areas exposed to the sun aka not in the T-shirt unilateral perioral - spares the mouth retro-articular - behind the ear
What do the terms linear and annular mean?
Linear - straight configuration
Annular - circular configuration
What are some patterns of skin disorders?
Lichenoid - epidermal basal layer damage
Psoriasiform - regular epidermal hyperplasia
Spongiotic - intraepidermal and intercellular edema - eczematous
Vesiculobullous - presence of vesicles/bullae
What are some pharmacological treatments of psoriasis?
Moisturizer Topical therapy Mild potent topical steroid including calcipotriol Topical steroids Topical tar Phototherapy Methotrexate, Cyclosporin If these don't work, consider biologics
What does psoriasis act as a risk factor for?
Depression
Anxiety
Hypertension
Vascular disease
What are some non-pharmacological treatments of psoriasis?
Baths
Losing weight
A bit of sunlight
