Psoriasis: The Basics - Answer-- chronic multisystem disease with predominantly skin and joint manifestations
- Affects approximately 2% of the U.S. population
- Age of onset occurs in two peaks: ages 20-30 and ages 50-60, but can be seen at any age
- There is a strong genetic component
- About...
Psoriasis Exam Questions with Verified
Answers
Psoriasis: The Basics - Answer-- chronic multisystem disease with predominantly skin
and joint manifestations
- Affects approximately 2% of the U.S. population
- Age of onset occurs in two peaks: ages 20-30 and ages 50-60, but can be seen at any
age
- There is a strong genetic component
- About 30% of patients with psoriasis have a first-degree relative with the disease
- Waxes and wanes during a patient's lifetime, is often modified by treatment initiation
and cessation and has few spontaneous remissions
Classification of Psoriasis
is based on morphology - Answer-- plaque
- inverse/flexural
- guttate
- erythrodermic
- pustular
- Clinical findings in patients frequently overlap in more than one category
- Different types of psoriasis may require different treatment
Plaque - Answer-scaly, erythematous patches, papules, and plaques that are
sometimes pruritic
Inverse/flexural - Answer-lesions are located in the skin folds
Guttate - Answer-presents with drop lesions, 1-10mm salmon-pink papules with a fine
scale
Eryhtrodermic - Answer-generalized erythema covering nearly the entire body surface
area with varying degrees of scaling
Pustular - Answer-- clinically apparent pustules
- Rare, acute generalized variety called "von Zumbusch variant"
- Palmoplantar - localized involving palms and soles
Guttate Psoriasis - Answer-- Acute onset of raindrop-sized lesions on the trunk and
extremities
- Often preceded by streptococcal pharyngitis
Inverse/Flexural Psoriasis - Answer-- Erythematous plaques in the axilla, groin,
inframammary region, and other skin folds
- May lack scale due to moistness of area
, Pustular Psoriasis - Answer-- Characterized by psoriatic lesions with pustules.
- Often triggered by corticosteroid withdrawal.
- When generalized, pustular psoriasis can be life-threatening.
- These patients should be hospitalized and a dermatologist consulted.
Palmoplantar Psoriasis - Answer-- May occur as either plaque type or pustular type.
- Often very functionally disabling for the patient.
- The skin lesions of reactive arthritis typically occur on the palms and soles and are
indistinguishable from this form of psoriasis.
Psoriatic Erythroderma - Answer-- Involves almost the entire skin surface; skin is bright
red
- Associated with fever, chills, and malaise
- Like pustular psoriasis, hospitalization is sometimes required
Plaque Psoriasis - Answer-- Well-demarcated plaques with overlying silvery scale and
underlying erythema
- Chronic plaque psoriasis is typically symmetric and bilateral
- Plaques may exhibit:
a. Auspitz sign (bleeding after removal of scale)
b. Koebner phenomenon (lesions induced by trauma
Plaque Psoriasis: The Basics - Answer-- is the most common form, affecting 80-90% of
patients
- Approximately 80% of patients with plaque psoriasis have mild to moderate disease -
localized or scattered lesions covering less than 5% of the body surface area (BSA)
- 20% have moderate to severe disease affecting more than 5% of the BSA or affecting
crucial body areas such as the hands, feet, face, or genitals
Psoriasis: Pathogenesis - Answer-- Psoriasis is a hyperproliferative state resulting in
thick skin and excess scale
- Skin proliferation is caused by cytokines released by immune cells
- Systemic treatments of psoriasis target these cytokines and immune cells
Ask About Past Medical History for Psoriasis - Answer-- Psoriasis can be triggered by
infections, especially streptococcal pharyngitis
- Psoriasis can be more severe in patients with HIV
- Up to 20% of psoriasis patients have psoriatic arthritis, which can lead to joint
destruction
- There is a positive correlation between increased BMI and both prevalence and
severity of psoriasis
- Patients with psoriasis may have an increased risk for cardiovascular disease and
should be encouraged to address their modifiable cardiovascular risk factors
- also family history, meds, & social history
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