Psoriasis

Question 1

Case

Answer 1

27 year old over weight male worsening of a prior chronic mild rash , mild redness and
some scaling of his elbow and scalp , no systemic signs denies joint pain

Question 2

Pathology

Answer 2

1)Chronic T cell mediated inflammation
2)HLA C06 - early onset psoriasis
3)HLA B 27 - psoriatic arthritis
4)Risk factors - family history , smoking , alcohol , obesity , medication (NSAIDs , corticosteroids) ,
infection

Question 3

Lesion

Answer 3

Well demarcated erythematous plaques with silver scales

Question 4

Differential diagnosis

Answer 4

1)Dermatitis
2)Lichen planus
3)Lichen sclerosus

Question 5

Dx

Answer 5

1)Clinical evaluation
2)Signs =
auspitz sign
Koebner phenomenon
Grattage test
Candle grease sign
Wornoff ring
3)Nails pitting
4)Biopsy = micro abscess dilated blood vessels in dermal papilla

Question 6

Treatment

Answer 6

1)Topical steroids
2)Keratocytic (salicylic acid and urea )
3)Vitamin D and A
4)Immunomodular methotrexate
5)Biological agents TNF a
6)Phototherapy