Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
IOS 9 Exam 2
Psoriasis
| Question | Answer |
|---|---|
| Etiology of Psoriasis | Genetic factor PSORS 1 loci and exogenous triggers (wather, stress, infection, trauma, medication, (lithium, BB, antimalarials, ACE-i, NSAIDS, tetracyclines, and INF |
| Pathophysiology of psorisis 4 steps | 1. Antigen processing by antigen presenting cells (macrophages) 2. Antigen presentation to naive T-cells 3. Movement of T-cells to skin 4. Reactivation of T-cells in the dermis release of cytokines TNF alpha |
| Result of pathogenic T-cell production and activation | Psoriatic epidermal cell proliferation at a rate that is seven fold faster than normal epidermal (37.5 vs 300 hours) |
| Goals of psoriasis treatment | Skin normalization, reduction or clearing or papules, plaques, scales, improve QOL, minimize SE of medications |
| Emollients are used | Often used during therapy free periods to minimize skin dryness that may lead to early recurrence. They hydrate stratum coreumand minimize water loss |
| Side effects of emollients | Folliculitis and allergic or irritant dermititis |
| Epidemiology of psoriasis | 2-3% of pupulation, caucasians are predominate, Bimodal onset 20-30 or 50-60yo, is cyclical or continous presense of thickened, erythematous,scaling plaques |
| Signs of psorosis | Sharply demarkated, erythematous papules and plaques (silvery white) with small papules and removal of scales exposes pink, erythamateous lesions (blled-Auspitz) |
| Psoriasis is rated by PASI and %BSA | Mild PASI <12, Moderate 12-18 and Severe >18 severe is BSI >20% |
| Most common form of psoriasis is | Plaque Psoriasis |
| Balneotherapy is | A theraputic approach that consists of bathing in waters containing certain salts |
| Ultraviolet B Phototherapy- | Used in compination with topicals and or systemic therapy (310-315 best) |
| Guttate Psoriasis | Classically it follows and B-hemolytic infection of Strep infection. Looks like dots or pink papules |
| Putular psoriasis | Pus like blisters (WBC), localized to the palms and soles most common in patient swho have withdrawn from corticosteroids |
| Erythrodermic psoriasis | Exfoliation of sine scales often a severe pruitis (itch) and pain, BSA >90%, most common when systemic corticosteroids are withdrawn (life threatening) |
| Nail psoriasis | More often finger>toe, 4 clicinal changes onchyolysis, pitting *, yellow coloring, oil spots |
| Psoriatic arthritis | Commonly seen in patients with scalp or nail psoriasis, difficult to distingusih from RA |
| Topical 1st line | Keratolytics, topical corticosteroids (high, medium, low), vitamin D analoges, Tazarotene) |
| Systemic 1st line | Acitretin (not for femles and want baby-3 years) |
| Systemic 2nd line | Methotrexate |
| 3rd Line systemics | Biologics (Cyclosporine, Tacrolimus, Mycophenolate, Infliximab, Etanercept, Alefacept, Efalizumab) |
| Phototherapy 2nd line | Coal tar is applied to skin and UVA (more penetration) and UVB light are used. Methoxasalen used with UV therapy topically or orally- 20 treatments |
| Scalp psoriasis | Does not respond to oil vechiles best with tar shampoo and corticosteroid or solution vehicle |
| Nail psoriasis | FOr oncholysis a topical corticosteroid in a solution vehile maybe used under the nail. Possible systemic therapy |
| Genitalia psoriasis | A low potency topical corticosteroid oinment is recommended. Topical calcipotriene maybe used |
| Palms and soles | Thick areas require the highest potencycorticosteroid, methotrexate or acitretin may be needed |
| MOA of keratolytics | Disruption in corneocytes to corneocyte cohesion in the abnormal horny layer of psoriatioc skin |
| Brands of keratolytics | Salicylcylic acid (Kerlyt, Lupicare Psoriasis) |
| Topical Corticosteroids | Appear to inhibit phospholipase A and subsequently reduce levels af arachidonic acid, PG and leukotrienes in the skin |
| Topical corticosteroids which are Vey high potency | Desoximetasone |
| High potency Corticosteroids | Triamcinolone acetonide |
| Medium potency | Hydrocorticone butyrate |
| Low potency | Desonide |
| Very low potency | Dexamethasone, prednisolone, Methylprednisolone |
| Vitamine D analog brand | Dovonex |
| Coal tar brands | Balnetar, neutrogena T/Gel, Cutar |
| Anthralin brands | Drithocreme, Dritho-scalp, Psoriatec |
| MOA of Vitamin D analog | Anti-inflammatory shift toward Th2, decrease IL-8 and increase IL 10 |
| MOA of tazarotene | Topical retinoid that modulates keratinocyte proliferation and differation |
| Coal Tar MOA | Stimulates transient epidermal hyperplasia followed by cytostatic effect with epidermal thinning |
| Anthralin MOA | Antiproliferative activity on human keratinocytes inhibiting DNA |
| Brands of anthralin | Drithocreme, Dritho-scalp, Psoriatec |
| MOA of Acitretic | Soriatane is a retinoid analog that acts on retinoid receptors in keratinocyte nucleus to correct abnormal cell differentiation-contraindicated in alcoholics, pregnancy,lactating, renal function, monitor LFT, Lipids at baseline and Q 1-2, and blood gluc |
Created by:
liza001
Popular Pharmacology sets