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What is a papule?
- Papules
- - A discrete, solid, elevated body usually less than .5 cm in diameter
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Describe a plaque
- Plaques - A discrete, solid, elevated body usually broader than it is thick measuring more than .5 cm in diameter
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What is a pustule?
- Pustules - small inflamed elevations of the skin that are filled with pus
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Describe Erythroderma
- Erythroderma- Generalized blanchable redness of the skin that may be associated with desquamation or extensive scaling
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What are the trigger points for psoriasis vulgaris?
- Physical trauma (Koebner phenomenon)
- Infections (acute strep infection precipitates guttate psoriasis)
- Stress
- Drugs
- EtOH ingestion
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What is this?
Eruptive, acute guttate psoriasis
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Tell me about acute guttate psoriasis
- Rare
- Resolves spotaneously
- Eruptive, inflammatory type
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What is this?
Chronic, stable psoriasis plaque
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What is the "classic" description of chronic?
A sharply marginated erythematous papule/plaque with a silvery-white scale
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What is the Auspitz sign?
The appearance of minute blood spots when psoriatic scales are removed
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What is the common distribution of psoriasis?
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What is this describing?
Salmon-pink papules 2.0 mm to 1.0 cm with or without scales concentrated on trunk
Acute guttate psoriasis
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Where is acute guttate psoriasis distributed?
Generalized but mostly on trunk
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Where is chronic stable psoriasis distrbuted?
Single or multiple lesions at common sites
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Special psoriasis sites
- Palms and soles: there may be cracking and pain
- Scalp: pruritic, NO hair loss
- Face: associated with refractory psoriasis
- Inverse psoriasis: body folds, perianal and genital regions. Bright RED, sharply demarcated
- Nails: nail pitting and yellow-brown spots, erythematous cuticles
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Describe pustular psoriasis:
- Pustules on normal or erythematous skin.
- Palmoplantar pustulosis or generalized acute pustular psoriasis
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What triggers psoriatic erythroderma?
Occurs following excessive ultraviolet exposure or as a complication of aggressive topical therapy or systemic viral or bacterial disease
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Mangement of psoriasis
- Topical treatments: emollients, topical steroids
- Phototherapy: UVB, psoralin + UVB
- Oral meds: Lin's drugs
- Lifestyle mod
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What is this?
Reddish orange scaly plaques with islands of sparing, palmoplantar keratoderma, and keratotic follicular papules
Pityriasis rubra pilaris
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What is the progression and distribution of Pityriasis
rubra pilaris?
- Crainocaudal
- Lesions expand over whole body
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Tx fo pityriasis rubra pilaris
- Topical Treatment
- Methotrexate
- Phototherapy (UVB)
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Herald patch
Christmas tree distribution
Pityriasis rosea
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Tx for pityriasis rosea
- Self-limited
- Corticosteroids for itch
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Lace-like Wickham striae seen on lichen plaques
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