Psoriasis Exam 35 Questions with Answers Latest,100% CORRECT

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Psoriasis Exam 35 Questions with Answers Latest Demographics - CORRECT ANSWER 2% UK Male=female (chronic plaque Onset any age but commonly <40. Average age 33. Females earlier than males (hormon... es) Psoriasis pathogenesis - CORRECT ANSWER Hyperproliferative disorder where the life cycle of keratinocytes shortens causing a 28x normal production of epidermal cells. T-cell medicated. Psoriasis characteristics - CORRECT ANSWER - red, silver scaling, symmetrical plaques, well circumscribed - elbows, knees, scalp, sacrum - nails are affected in 50% - arthritis in 15% Types of psoriasis - CORRECT ANSWER - Chronic plaque is most common 90% - guttate - erythrodermic - flexural - pustular - sebopsoriasis Psoriasis pictures - CORRECT ANSWER Well defined erythematous plaque with fine scaling Hand psoriasis - CORRECT ANSWER Begins in pressure bearing areas and dominant handedness Less well demarcated psoriasis Scalp psoriasis - CORRECT ANSWER well defined edge, doesn't extend onto the forehead like seborrhoeic dermatitis DD Seborrhoeic dermatitis - CORRECT ANSWER DD Pityriasis amiantacea - CORRECT ANSWER Scales which ensheath and bind down tuft of hairs. Removal of scales can cause erythematous hairless skin. Isolated idiopathic phenomenon. Women average age 25. Resolves over months to few years. Erythroderma psoriasis - CORRECT ANSWER Flexural psoriasis - CORRECT ANSWER Occurs in groin, axillae, inframammary, intergluteal, antecubital, popliteal fossae Appears smooth and salmon coloured Obese patients are more prone Exacerbated by the friction DD for flexural disease - CORRECT ANSWER Seborrhoeic dermatitis Candidiasis Tinea cruris Contact/irritant dermatitis CTCL Auspitz sign - CORRECT ANSWER pinpoint bleeding after a scale is removed shows the high vascularity of lesion Guttate psoriasis - CORRECT ANSWER - means droplet shaped - precipitated by *strep infection* present 2 weeks after pharyngitis or tonsillitis - commonest in childhood - self-limiting - 40% go on to develop chronic plaque psoriasis palmoplantar pustular psoriasis - CORRECT ANSWER Rare, not associated with HLA-Cw6 Female:male 9:1 >90% ex or current smokers 25% have chronic plaque psoriasis Associated with thyroid disease Generalised pustular psoriasis - CORRECT ANSWER Medical emergency form of plaque psoriasis Comorbidities with psoriasis - CORRECT ANSWER - Ocular inflammation - IBD - arthritis - spondyloarthropathies - nail disease - psychosocial Effects of psoriasis on the nails - CORRECT ANSWER 50% have nail involvement - pitting - onycholysis - longitudinal ridging - sub-ungual hyperkeratosis - oil spots - dystrophy Nail psoriasis - CORRECT ANSWER Cardiovascular disease and psoriasis - CORRECT ANSWER DM, hyperlipidaemia, HTN, higher BMI, MI with severe psoriasis Gene associated with psoriasis - CORRECT ANSWER HLA-Cw6 What are the 2 types of psoriasis? - CORRECT ANSWER Type 1 is earlier onset <40 75% Type 2 psoriasis is older onset >40 and not as associated with HLA-Cw6 May be different diseases? Histological appearance of psoriasis - CORRECT ANSWER Epidermal hyperplasia Dilated and prominent blood vessels Infiltrate of leucocytes Cytokines in psoriasis - CORRECT ANSWER TNFa, IL-17 Triggers for psoriasis - CORRECT ANSWER Infection - strep - HIV Skin trauma - koebnar (site of trauma) Drugs - B-blockers - NSAIDs - lithium - anti-malarials Stress Alcohol Endocrine - pregnancy, hypocalcaemia Prognosis - CORRECT ANSWER Treatment is suppressive, no cure 50% go into remission at some time but <10% permanent Mild psoriasis - CORRECT ANSWER - <10% BSA - may remit spontaneously - stable - rarely requires continuous therapy Topical therpaies - CORRECT ANSWER - Emollients - Keratolytics - Coal tar - Dithranol - Glucocorticosteroids - Vit D analogues - calcipotriol, calcitriol, tacalcitol - tazarotene Severe psoriasis - CORRECT ANSWER Covers more than 10% of the body and can have a severe impact on the quality of one's life Second-line therapy - CORRECT ANSWER Photottherapy - UVB Photochemotherapy - PUVA Inpatient Systemic agents - acitretin - methotrexate = folic acid anatagonist - ciclosporin Biologics Methotrexate SEs - CORRECT ANSWER Hepatotoxicity, bone marrow suppression, nausea Ciclosporin SEs - CORRECT ANSWER HTN, nephrotoxicity PUVA SEs - CORRECT ANSWER Skin cancer, photoageing Acitretin SEs - CORRECT ANSWER Hyperlipidaemia, hepatotoxicity Biologics - CORRECT ANSWER Anti-TNF - etanercept - infliximab (IV) - adalimumab Anti-IL12/IL-23p40 - ustekinumab [Show More]

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