psoriasis

Question 1

what are the different types of psoriasis

Answer 1

• psoriasis vulgaris (chronic plaques)
• guttae
• palmoplantar pustular
• erythrodermic (red body)
• pustular

Question 2

what is the most common type of psoriasis

Answer 2

psoriasis vulgaris

Question 3

what is psoriasis

Answer 3

non-ending super accelerated wound healing so overactive keratin

Question 4

cause of psoriasis

Answer 4

• genetics
• bacterial pharyngitis
• HIV
• psychological stress
• beta blockers/lithium

Question 5

comobidities of psoriasis

Answer 5

• psoriatic arthritis
• obesity
• hypertension
• diabetes
• crohn’s
• cancer
• depression
• uveitis

Question 6

presentation of psoriasis

Answer 6

patches of skin that are dry, red and covered in silver scales

• may be itchy or sore
• on extensors, scalp, sacrum, hands, feet, trunk and nails

Question 7

what are some specific signs of psoriasis

Answer 7

• AUSPITZ sign refers to small points of bleeding when plaques are scraped off
• KOEBNER PHENOMENON refers to development of psoriatic lesions to areas of skin affected by trauma
• RESIDUAL PIGMENTATION of the skin after the lesions resolve

Question 8

features of nail psoriasis

Answer 8

• onycholysis
• pitting
• dystrophy
• subungual hyperkeratosis

Question 9

what is guttate psoriasis

Answer 9

small papules across trunk and limbs

• mild erythema and can be slightly scaly
• can turn into plaques

Question 10

what is pustular

Answer 10

rare severe form where pustules form under areas of erythematous skin

• medical emergency
• patients can be systemically unwell

Question 11

what are some topical therapies for psoriasis

Answer 11

• emollients
• vitamin D analogues (calcipotriol, calcitriol)
• steroid ointment
• coal tar
• dithranol

Question 12

what is phototherapy for psoriasis

Answer 12

narrowband UVB and PUVA

Question 13

systemic treatments for psoriasis

Answer 13

• methotrexate

- biological agents

Question 14

treatment for scalp psoriasis

Answer 14

• greasy ointment
• tar shampoo
• steroids in alcohol base or shampoo
• Vit D analogues

Question 15

immunology of psoriasis

Answer 15

• KC under stress release factors which stimulate pDC to produce IFNa. They also release IL-1B/IL-6 and TNF
• chemical signals activate DC which migrate to lymph nodes to present to and activate TH1 and TH17
• T cells are attracted to dermis by chemokines and secrete IL-17A/17F and 22 which stimulates KC proliferation, AMP release and neutrophil-attracting chemokines
• dermal fibroblasts become involved which release KC and epidermal growth factors