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1287724
Psoriasis (2)
Description
Mind Map on Psoriasis (2), created by r.wallace5801 on 09/14/2014.
Mind Map by
r.wallace5801
, updated more than 1 year ago
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Created by
r.wallace5801
over 10 years ago
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Resource summary
Psoriasis (2)
Area of the body affected
Scalp
Overnight treatment of salicylic acid
Tar preparations
Oil preparations
Olive oil or coconut oil
Facial and flexor surfaces
Moderate corticosteroids e.g. cloebastone butyrate first
Vitamin D analogues or tacrolimus ointment for intermittent use
Widespread
Dithranol and potent steroids are not recommended
Second line management
Narrow-band UVB
Offered to patients with plaque psoriasis which is not controlled by topical steroids
Given 2/3 times a week
Time and accessibility to UVB equipment
Photochemotherapy
Treats more extensive or resistant disease
Given 2/3 times a week
Side effects
Nausea, burning sensation and pruritus
Increased risk of skin damage and cancer
Combined with oral retinoid derivative to decrease dose of UVA
Systemic agents
Given for severe or refractory psoriasis
Given to those with resistant psoriasis with significant impact on physical and psychological wellbeing
First choice
Ciclosporin for rapid or short term control, palmopalantar pustulosis or considering contraception
Short term use 4-12 weeks
Everyone else- methotrexate
Extensive chronic plaque psoriasis
Increase transamines and long term associated with liver fibrosis
Second choice
Acitretin
Severe extensive psoriasis resistant to other therapy
Combined with other treatments
Fumaric acid
Alternative others mentioned
Biological therapies
TNF medications
Disease must be severe
Psoriasis is not responding to alternative treatments
Prognosis
Early onset and family history- poor indicators
Pustular flares may be provoked by systemic corticosteroid therapy
Triggers
Strepococci infection
Guttate psoriasis
Appearance
Scaly skin eruption which is symmetrical
Mainly form over the trunk and limbs
Crops of papules and small plaques with overlying scaling
Seen in young adults
Management
UVB phototherapy for thin plaques
Erythromycin for throat
Can evolve into chronic plaque psoriasis in patients with positive family history of psoriasis
Group A beta-haemolytic streptococci
Erythrodemic psoriasis
Entire skin becomes red
Dermatological emergency which is associated with fever, rigor and lymphadenopathy
Management
Mild topical steroids
Enter text here
Other causes of erythrodema
Atopic eczema
Cutaneous T cell lymphoma
Allergic contact dermatits
Seborrhoeic dermatits
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