Psoriasis and papulosquamous disorders

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Psoriasis and papulosquamous disorders
2012-04-22 13:55:13

West's lecture
Show Answers:

  1. What is a papule?
    • Papules
    • - A discrete, solid, elevated body usually less than .5 cm in diameter
  2. Describe a plaque
    • Plaques - A discrete, solid, elevated body usually broader than it is thick measuring more than .5 cm in diameter
  3. What is a pustule?
    • Pustules - small inflamed elevations of the skin that are filled with pus
  4. Describe Erythroderma
    • Erythroderma- Generalized blanchable redness of the skin that may be associated with desquamation or extensive scaling
  5. What are the trigger points for psoriasis vulgaris?
    • Physical trauma (Koebner phenomenon)
    • Infections (acute strep infection precipitates guttate psoriasis)
    • Stress
    • Drugs
    • EtOH ingestion
  6. What is this?
    Eruptive, acute guttate psoriasis
  7. Tell me about acute guttate psoriasis
    • Rare
    • Resolves spotaneously
    • Eruptive, inflammatory type
  8. What is this?
    Chronic, stable psoriasis plaque
  9. What is the "classic" description of chronic?
    A sharply marginated erythematous papule/plaque with a silvery-white scale
  10. What is the Auspitz sign?
    The appearance of minute blood spots when psoriatic scales are removed
  11. What is the common distribution of psoriasis?
  12. Psoriasis vulgaris
  13. What is this describing?
    Salmon-pink papules 2.0 mm to 1.0 cm with or without scales concentrated on trunk
    Acute guttate psoriasis
  14. Where is acute guttate psoriasis distributed?
    Generalized but mostly on trunk
  15. Where is chronic stable psoriasis distrbuted?
    Single or multiple lesions at common sites
  16. Special psoriasis sites
    • Palms and soles: there may be cracking and pain
    • Scalp: pruritic, NO hair loss
    • Face: associated with refractory psoriasis
    • Inverse psoriasis: body folds, perianal and genital regions. Bright RED, sharply demarcated
    • Nails: nail pitting and yellow-brown spots, erythematous cuticles
  17. Pustular psoriasis
  18. Describe pustular psoriasis:
    • Pustules on normal or erythematous skin.
    • Palmoplantar pustulosis or generalized acute pustular psoriasis
  19. psoriatic erythroderma
  20. What triggers psoriatic erythroderma?
    Occurs following excessive ultraviolet exposure or as a complication of aggressive topical therapy or systemic viral or bacterial disease
  21. Mangement of psoriasis
    • Topical treatments: emollients, topical steroids
    • Phototherapy: UVB, psoralin + UVB
    • Oral meds: Lin's drugs
    • Lifestyle mod
  22. What is this?
    Reddish orange scaly plaques with islands of sparing, palmoplantar keratoderma, and keratotic follicular papules
    Pityriasis rubra pilaris
  23. What is the progression and distribution of Pityriasis
    rubra pilaris?
    • Crainocaudal
    • Lesions expand over whole body
  24. Pityriasis rubra pilaris
  25. Tx fo pityriasis rubra pilaris
    • Topical Treatment
    • Methotrexate
    • Phototherapy (UVB)
  26. Herald patch
    Christmas tree distribution
    Pityriasis rosea
  27. Pityriasis rosea
  28. Tx for pityriasis rosea
    • Self-limited
    • Corticosteroids for itch
  29. Lace-like Wickham striae seen on lichen plaques