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56 Cards in this Set
- Front
- Back
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A chronic, erythematous, scaly condition w/ unknown etiology that affects 1-2% of the population, men=women, and is more common in caucasions, +30% have F.H., that usually begins in teens/20's, that carries a high psychological component is....
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psoriasis vulgaris (as in acne)
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psoriasis is a __ inflammatory condition
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chronic
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psoriasis is considered a type IV disease involving __ cells.
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T cells
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psoriasis is an example of epidermal __
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hyperproliferation
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psoriasis is the turnover from stratum ___ to stratum __ that is 7-9x's that of normal rate.
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germanitevum to corneum
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What condition results in epidermal buildup of typical thickened, silvery white micaceous (scaly) plaques?
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psoriasis
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psoriasis results in increased cell __, with rapid turnover of keratinocytes, fibroblasts, an d__ cells.
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mitosis,
rapid turnover of keratinocytes, fibroblasts, and endothelial cells |
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psoriasis results in inflammation of the __ and __
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dermis and epidermis
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There is an accumulation of t-lymphocytes, monocytes, and ___'s with psoriasis.
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PMN's
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PMN's accumulate in the stratum __ forming characteristic microabcesses
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corneum
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What dermatologic dx distribution may involve few plaques or papules or cover extensive surface area, is usually symmetric, often found on large extensor joints (elbows/knees/knuckles) palms, soles, anogenital and perineum, scalp and retroauricular (seborrhiasis) areas called?
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psoriasis
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scalp and retroauricual psoriasis is AKA?
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seborrhiasis
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psoriasis is usually found over the large ___ joints and is usually symmetrical.
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extensor
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guttate (teardrop-shaped) large plaques or papules are found on the ?
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trunk
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psoriasis found in the axillae, infuinal creases, inframammary, or perineum regions are called?
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inverse psoriasis
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nail psoriasis is found in about 1/3 of cases and is often mistaken for ?
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onychomycosis
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psoriatic arthritis is found in _-_% of patients with psoriasis?
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5-10
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psorasis is usually __
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asymptomatic
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pruritis can be severe especially in the scalp and __ psoriasis
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inverse
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painful fissuring can occur on the __ and__
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palms and soles
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What is Kobner's phenomenon?
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new lesions appear at site's of trauma, injury, or excoriation
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what psycho/social factors may worsen psoriasis?
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etoh abuse
drugs: b-blockers, antimalarials, ACE, Li+ trauma, surgery, infxn, thermal or chemical burns |
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Withdrawal of potent topical or systemic steroids may, rarely, trigtger severe, fatal __ __
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pustular psoriasis
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T/F
psoriasis is usually better controlled in the winter. |
false, psoriasis does better with sun exposure so it improves in summer, worsens in winter.
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When does psoriasis peak?
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it has a bimodal peak
-20's -50's |
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Which disease condition has a erratic, unpredictable, waxing and waning course; in which environmental factors influence severity, that has a bimodal peak, degree of pruritis varies and improves with sunlight?
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psoriasis
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how is psoriasis diagnosed?
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clinically-typical well-demarcated white to silver plaque/scaly papules with +FH, typical nail findings, skin bx, KOH to r/o fungal infection
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what is the cornerstone of tx of pt's with psoriasis?
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potent topicals, then tapering to less potent meds for maintainence. Initially may be occlusive drsg with med-high dose steroid covered in saran wrap. `
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What is the intradermal tx of psoriasis?
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intra-plaque triamcinolone with 30g. needle until blanching occurs
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What does Dovonex (Vit D3) do for psoriasis?
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slows the epidermal hyperproliferation, thins psoriatic plaques, and removes scalse.
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when is phototherapy used?
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for extensive, moderate to severe plaque psoriasis, UVB has less side-effects, and is used first.
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When is eximer laser UVB used?
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high-dose light therapy for severe psoriasis
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What drug is used in immune disorders?
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methotrexate (MTX)
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When is MTX used?
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extensive chronic plaque dx
useful for psoriatic arthritis antimetabolite, inhibis DNA synthesis |
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How is MtX given?
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low dose weekly treatment, give folic acid on non-tx days
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what lab value must be monitored when giving a pt mtx?
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liver enzymes
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long term use of mtx may result in __
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myelosuppression
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What is Acitretin?
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a synthetic vit A that is antiproliferative, antiinflammatory, and antikeratizing
can be teratorgenic? |
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what role does cyclosporine play in the tx of psoriasis?
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suppresses delated type 4 hypersensitivity rxns.
must monitor liver and kidney fcn q 4-6 months-risk of myelosuppression |
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What is the role of 'biologicals' on psoriasis?
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suppress t-cell mediated proceses and inflammatory mechanisms.
inhibit cytokines, t-cell activation, tnf |
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what is etanercept (enbrel)?
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a sub-q injection that is a tnf receptor bound to Fc portion of IgG
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What is humira?
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a recombinant IgG1 monoclonal Ab which binds to TNF
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what is the most common form of psoriasis?
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localized patches found on elbows and knees
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Definition: Sudden appearance of generalized arthema, scaling, and exfoliation.
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exfoliative psoriasis
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What is the tx of exfolliative psoriasis?
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in addition ot generalized therapy...bed rest, cool compresses, lubricating emollients, antipruiritic antihistamines, hospitalization if severe.
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Definition: What is a sudden onset of multiple guttate psoriatic lesions, often initial presentaiton of psoriasis in adolescence, sometimes preceded by strep infection?
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acute guttate psoriasis
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what is the treatment of guttate psoriasis?
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appropriate abx
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psoriasis in kids,,,some stats....please
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10% begin before age 10
may begin as diaper rash often + FH early presentation often more severe |
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Children with psoriasis...
T/F high dose/short course steroids is the TOC. |
FALSE, avoid high dose topical steroids in kids.
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What is the most characteristic nail symptom in a pt with psoriasis?
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pitting
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yellow-brown discolorations under the nail plate is called? indicative of ?
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oil-spots
psoriasis |
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? what is "separtion of nail plate from nail bed"
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onycholysis
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Definition: scale build-up beneath the nail plate?
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subungual hyperkeratosis
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onychomycosis is aka...
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exzematous dermatitis
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psoriatic arthritis usually presents between the ages of __-__ & occurs in _-_% of pts with psoriasis.
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35-45 years old
5-10% of patients. |
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T/F
pt's with psoriatic arthritis will often have a positive RF lab |
false-often negative result
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