Psoriasis

Exam Cram

Psoriasis

Background

• Betablockers can cause exacerbations

Management

1. Topical steroids

2. Topical retinoids

3. PO Methotrexate

Erythrodermic psoriasis: 

1. Topical white soft paraffin with advise not to smoke (highly flammable)

2. Cyclosporin +- systemic steroids

Guttate psoriasis

• Post URTI rash- multiple small lesions

• Management: emollients

Psoriatic Arthritis

Background 

Seronegative arthropathy

20% psoriatric arthritis don't develop psoriasis

Examination:

• Psoriatic plaques

• Nail pitting

• Distal small joint arthropathy

Ix

• HLA B27

• Raised inflammatory markers

• Nil positive antibodies

Differentials

• Seronegative arthropathy: enteroarteritis, ankylosing spondylitis

• Seropositive: Rheumatoid Arthritis , Systemic Lupus Erythematous 

Management (N-MSG)

1. Naproxen

2. Methotrexate

3. Sulfasalazine

4. Mabs: golimumab or adalimumab

Comments

• Steroids can worsen psoriasis as well as cause osteoporosis etc so may cause more harm than good and preferably avoided but still used in clinical practice

• As a medic I have greater impetuous in the psoriatic arthralgia than actual psoriasis!

Created in 2024.