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Psoriasis Exam Questions with Complete Solutions

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Psoriasis - Answer-Chronic, multi-system disease Lifelong illness, can wax and wane Decreased QOL ad emotional distress Decreased life expectancy Epidemiology of psoriasis - Answer-Affects approx. 2% of the U.S. population (mainly caucasian) Affects men and women equally Two peaks of onset...

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Psoriasis Exam Questions with
Complete Solutions
Psoriasis - Answer-Chronic, multi-system disease
Lifelong illness, can wax and wane
Decreased QOL ad emotional distress
Decreased life expectancy

Epidemiology of psoriasis - Answer-Affects approx. 2% of the U.S. population (mainly
caucasian)
Affects men and women equally
Two peaks of onset: 20-30, 50-60

Etiology of psoriasis - Answer-Strong genetic component
Waxes and wanes throughout the lifetime
Triggers

What are the triggers of Psoriasis? - Answer-Injury to skin (trauma)
Psychogenic stress
climate (cold temperatures)
infection
smoking
alcohol
obesity
medications

Which medications exacerbate psoriasis? - Answer-NSAIDS, Antimalarials/ Ace
Inhibitors, Inderal, Lithium, Steroid withdrawal

What is the pathophysiology of psoriasis? - Answer-Immune mediated chronic
inflammatory disease of the skin. Activated T cells result in epidermal hyperplasia and
dermal inflammation. Cytokines and growth factors contribute to hyperproliferation of
basal cell keratinocytes. Caused by genetic and envt factors

Name the co-morbidities associated with psoriasis - Answer-Psoriatic Arthritis (PsA)
metabolic syndrome
Crohn's disease
Multiple sclerosis
Psychological illness ( anxiety and depression)
cutaneous T-cell lymphoma

Risks associated with Psoriasis - Answer-Decreased life expectancy
increased rates of mortality

, independent risk factor for atherosclerosis

Psoriasis types - Answer-Plaque
Inverse/Flexural
Guttate
Pustular
Erythrodermic
Psoriatic Onychodystrophy (Nail disease)

Plaque psoriasis - Answer---Well-demarcated plaques w/ white or silvery scale and
underlying red or gray patches
--Start as small papules which grow and unite to form plaques
--Chronic plaque psoriasis--symmetric and bilateral
--Auspitz sign--bleeding after removal of scale
--Koebner phenomenon--lesions induced by trauma

Guttate psoriasis - Answer-Individual small, fine red lesions/scales
Occurs in <2% of patients
Often preceded by bacterial infection such as strep throat

Inverse/Flexural psoriasis - Answer-Erythematous smooth plaques in the axilla, groin,
inframammary region and other skin folds
May lack scale due to moistness of area
More redness, almost looks like a burn

Pustular psoriasis - Answer-Localized pustules on palms and soles

Erythrodermic psoriasis - Answer---WIdespread large, red inflamed patches covering
most of BSA
--Can be gradual or acute
--Looks like an extreme burn
--Emergency situation, pt needs to be hospitalized

80% of psoriasis patients have mild-moderate disease - Answer-<5% BSA

20% of psoriasis patients have moderate-severe psoriasis - Answer->5% BSA

Past medical history - Answer---Can be triggered by infections
--More severe in patients with HIV
--20% of pts have psoriatic arthritis
--Increased BMI correlates with prevalence and severity of psoriasis
--Koebner Phenomenon

Family Hx of psoriasis - Answer---Strong genetic predisposition
--1/3 of pts have +family Hx

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