In-Depth Quiz on Psoriasis: Types, Symptoms, and Treatments

Dermatology

Medicine

ACGME

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| By Thames

Thames

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| Questions: 15

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1. Psoriasis Vulgaris typically affects which areas of the body?

Typical areas of palms and soles

Typical areas of chest and abdomen

Typical areas of elbows, knees, scalp, nails, usually sparing PALMS AND SOLES AND FACE-can be small papules to large plaques-Chronic... Typical areas of elbows, knees, scalp, nails, usually sparing PALMS AND SOLES AND FACE-can be small papules to large plaques-Chronic and recurrent course

Typical areas of face and neck

Psoriasis Vulgaris, specifically plaque psoriasis, often affects areas such as the elbows, knees, scalp, and nails while usually sparing the palms, soles, and face.

Explanation

Psoriasis Vulgaris, specifically plaque psoriasis, often affects areas such as the elbows, knees, scalp, and nails while usually sparing the palms, soles, and face.

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About This Quiz

Explore the complexities of Psoriasis, focusing on its symptoms, treatments, and diagnostic approaches. This educational resource is designed to enhance understanding for medical students and professionals, emphasizing practical knowledge and clinical skills.

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2. What is the characteristic feature of pustular psoriasis of palms and soles?

-a tender pustular eruption of the palms and soles where pustules come to the surface and desquamate, but DO NOT... -a tender pustular eruption of the palms and soles where pustules come to the surface and desquamate, but DO NOT RUPTURE-Higher prevalence in smokers-Very resistant tot standard therapy

Highly responsive to standard therapy

Low prevalence in smokers

Pustules rupture easily causing open sores

Pustular psoriasis of palms and soles is characterized by pustules that come to the surface and desquamate without rupturing, has a higher prevalence in smokers, and is very resistant to standard therapy.

Explanation

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3. What is pustular psoriasis of the digit also known as?

Aka: Acrodermatitis contnuaClinically: localized form of psoriasis, found on the finger with tender, eroded, and fissured surface-very resistant to standard... Aka: Acrodermatitis contnuaClinically: localized form of psoriasis, found on the finger with tender, eroded, and fissured surface-very resistant to standard therapy

Ringworm of the hand

Dermatitis of the wrist

Eczema of the toe

Pustular psoriasis of the digit is a localized form of psoriasis, typically found on the finger. It is characterized by a tender, eroded, and fissured surface and is known to be very resistant to standard therapy.

Explanation

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4. What is Generalized pustular psoriasis?

A common skin condition characterized by red, itchy patches covered with silvery scales.

A type of fungal infection causing pustules on the skin.

A benign skin condition caused by exposure to the sun.

Aka: pustular psoriasis of von ZumbuschClinically: Rare, serious disease with tiny sterile pustules coalescing into lakes of pus. -Pt is... Aka: pustular psoriasis of von ZumbuschClinically: Rare, serious disease with tiny sterile pustules coalescing into lakes of pus. -Pt is febrile, toxic, and elevated WBCTx: wet dressing, topical sterioids, but may require oral therapy with etretinate, MTX, or cyclosporine

Generalized pustular psoriasis, also known as pustular psoriasis of von Zumbusch, is a rare, serious disease characterized by tiny sterile pustules that coalesce into lakes of pus. Patients typically present with fever, toxicity, and elevated white blood cell count. Treatment involves wet dressing, topical steroids, and in severe cases, oral therapy with medications such as etretinate, methotrexate, or cyclosporine.

Explanation

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5. What is Erythrodermic psoriasis?

D. Autoimmune disorder that causes inflammation and scaling of the skin.

A. Mild form of psoriasis that can be easily managed with over-the-counter creams and lotions.

C. A condition characterized by patchy red skin covered with silvery scales.

-SEvere diseas usually occuring in previous psoriatic patients where precipitating factors, such as illness or stress, has lead to worsening... -SEvere diseas usually occuring in previous psoriatic patients where precipitating factors, such as illness or stress, has lead to worsening state-Tx: cool compresses, oatmeal baths, systemic therapy with etretinate or MTX

B. A type of fungal infection that primarily affects the nails and scalp.

Erythrodermic psoriasis is a severe form of the disease that can be triggered by various factors and requires systemic therapy for management. Options a, b, and c do not accurately describe Erythrodermic psoriasis, while option d vaguely describes the characteristics of psoriasis without specifying the severity and treatment required.

Explanation

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6. What is Inverse Psoriasis also known as?

Aka: psoriasis inversusClinically: intertiginous psoriasis( gluteal fold, groin, diaper area, etc) characterized by red, smooth plaques that commonly fissure at... Aka: psoriasis inversusClinically: intertiginous psoriasis( gluteal fold, groin, diaper area, etc) characterized by red, smooth plaques that commonly fissure at base of body crease

Option A: Psoriasis Vulgaris

Option C: Dermatitis

Option B: Eczema

Inverse Psoriasis is also known as psoriasis inversus or clinically as intertriginous psoriasis. It is characterized by red, smooth plaques that commonly fissure at the base of body crease. Options A, B, and C are incorrect as they refer to different skin conditions.

Explanation

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7. What is a treatment option for psoriasis?

Chemotherapy

Antihistamines

Less than 20% involved-Topical Steroids(in pulse doses)-Calcipotriol(Dovonox)-Antrhalin-Tar-UVB and lubricating agents or Tar-Tape of occlusive dressing-intralesional steroids

Antibiotics

Psoriasis is a chronic autoimmune condition that affects the skin. Treatment options typically include topical steroids, calcipotriol, anthralin, tar, UVB therapy, lubricating agents, and intralesional steroids. Antibiotics, antihistamines, and chemotherapy are not commonly used to treat psoriasis.

Explanation

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8. Which treatment(s) is/are recommended for psoriasis involving greater than 20% of the body?

-UVB and tar-PUVA-Systemic Tx: MTX, HYDREA, etretinate, cyclosporine*, hospitalization in severe cases

Antibiotics

Topical corticosteroids

Antihistamines

Psoriasis involving greater than 20% of the body may require more aggressive treatment options such as UVB and tar, PUVA, systemic medications like MTX, HYDREA, etretinate, and cyclosporine. Topical corticosteroids, antihistamines, and antibiotics may not be sufficient for severe cases of psoriasis.

Explanation

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9. What is Pityriasis Rubra Pilaris (PRP) characterized by?

C. A rare genetic disorder resulting in thickened nails and red skin patches on the face and upper body.

General: rare, chronic disease characterized by thickened and yellow palms and soles, erythroderma(red skin), "islands of sparing"Etiology: unknown, onset in... General: rare, chronic disease characterized by thickened and yellow palms and soles, erythroderma(red skin), "islands of sparing"Etiology: unknown, onset in adulthood or childhoodClinically:1. starts w/ red scaling plaque on face or upper body that enlarge over days to weeks with thickening of palms and soles2. skip areas of redness occur and follicular paupules on elbow and knee develop. NO ITCHING3. Other features: thickened nails, ectropion4. duration of disease is 3 years in 80% of pt5. Childhood PRP-> red to orage keratotic plaques confined to elbows and knees with longer chronic courseTX: lubricants, vit D3, retinoids,(accutane, etretinate) MTX

A. An acute, infectious disease characterized by a rash on the palms and soles with severe itching.

B. A condition caused by a vitamin deficiency leading to a yellowing of the skin on the palms and soles.

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10. Which of the following treatments is recommended for Seborrheic Dermatitis?

Scalp involvement:- nizoral shampoo, tar shampoo, sal acid, -steroid lotions of solutionsSkin involvement:-nizoral cream-zinc or selenium soaps-low potency steroids

Cortisone cream twice daily

Antifungal oral medication

Hydrocortisone shampoo

Seborrheic Dermatitis treatment usually involves specific shampoos, creams, and soaps tailored to the affected area and severity. Cortisone cream twice daily may be too strong for this condition, hydrocortisone shampoo is not typically used for Seborrheic Dermatitis, and antifungal oral medication is usually not the first line of treatment.

Explanation

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11. What is Pityriasis Rosea characterized by?

The age group most affected by Pityriasis Rosea is infants and toddlers.

Pityriasis Rosea typically lasts for several months and requires intensive medical treatment.

Pityriasis Rosea is caused by a bacterial infection.

General info: eruption on 2nd-3rd decade of life, winter and spring commonEtiology: unknown, thought to be viralclinically: ... General info: eruption on 2nd-3rd decade of life, winter and spring commonEtiology: unknown, thought to be viralclinically: Starts with single lesion "heral patch" usually on trunk resembling "ringworm" and 1 or 2 weeks generalized secondary eruption; the entire process remits spontaneously in 6 weeks without therapy-Pruritus absent 25% of time, mild 50% of time-Eruption is characterized by bright red, oval papules and plaques with fine collarette scale at periphery3.distribution: characterisic pattern "Christmas Tree pattern" on trunk and proximal aspect so arms and legs. rarely faceTx: self limited-tx the symptoms-antihistamines if itchy

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12. What is Lichen Planus?

General Info: chronic and recurrent inflammatory dermatosis characterized by flat-topped, violacious, shiny, pruritic papules and milky white papules in... General Info: chronic and recurrent inflammatory dermatosis characterized by flat-topped, violacious, shiny, pruritic papules and milky white papules in the mouth. 5 P's of Lichen Planus: Pruritic, Planar, purple, polyangular, papulesB. 30 to 60 years, Female>males, 10% familialC. Etiology: unknown, drugs may induce eruptionD. Clinically: 1. Flat- topped violacious purple papules with white lines (wickham's striae)2. grouped, linear, annular, or disseminated scattered discrete lesions3. wrist(flexor) lumbar region, eyelids, shins, scalp, and glans penis4. Mucous membranes 40-60% of individuals with LPE. patterns of LP:-actinic-annular-atrophicErosioulcerative-follicularGluttate-hypertrophic-linearnail disease-papularVesiculobullousF. prognosis: Treatment: topical and intralesional corticosteroids-oral prednisone, retinoids, cyclosporine, PUVA

A. A benign skin condition caused by exposure to sunlight.

C. A hereditary condition that affects the nails.

B. A type of virus that causes skin rashes.

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13. What is Lichen Striatus?

B. A condition that primarily affects males over the age of 40

C. Caused by a known bacterial infection

General Info: uncommon, unilateral and linear eruption of erythematous, flat topped and scaly papules that may go length of... General Info: uncommon, unilateral and linear eruption of erythematous, flat topped and scaly papules that may go length of limbB. age of onset 3-14 years, Females >malesC. Etiology: unknownD. Spontaneous involution occurs by 9 months, but can be treated with high potency top. steroids, and intralesional steroids

A. A common bilateral eruption of raised and itchy papules

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14. What is Lichen Sclerosus et Atrophicus?

C. A type of autoimmune disorder affecting the central nervous system.

B. A genetic disorder that primarily affects children under the age of 1.

General: chroinc mucocutaneous disorder, with white angular, well defined indurated papules and plaquesB. age of onset: mainly adults,... General: chroinc mucocutaneous disorder, with white angular, well defined indurated papules and plaquesB. age of onset: mainly adults, but children 1-13yo-Female: male 10 to 1C. etiology: unknownD. Clinically:-1. nongenital lesion are usually aymptomatic; genital often asymptomatic, however, vulvar lesion can be very painful2. Whitish, sharply demarcated, macules and forming plaques with keratin plugs (dells)3. kraurosis vulvae- femal vulvar plaques with "keyhole" or hour glass shape; lesions may be macerated and vulva may atrophy and shrink. 4. balanitis xerotica obliterans- in maless, prepuce becomes sclerotic and cant retract-> phimosis5. Squamous cell carcinoma, although uncommon may develop with lesions Prognosis and Tx:1. waxes and wanes, may resolve on it's own2. patients shoudl be followed every 12 months to check carcinoma3. topical corticosteroids, topical testosterone, antimalarials, circumcision in males

A. An infectious disease caused by a specific type of bacteria.

Lichen Sclerosus et Atrophicus is a chronic mucocutaneous disorder with specific clinical features and treatment options as described in the correct answer. The incorrect options do not accurately describe the condition and its characteristics.

Explanation

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15. What is Pityriasis Lichenoides?

An autoimmune disorder affecting the skin

A rare form of skin cancer

A contagious viral skin infection

Aka: Mucha-Habermann disease2. benign, self limited papulosquamous disease, with crops of reddish brown papulonecrotic lesions in clusters. Trunk and ext... Aka: Mucha-Habermann disease2. benign, self limited papulosquamous disease, with crops of reddish brown papulonecrotic lesions in clusters. Trunk and ext most comon3. lesions become necrotic an fade over 2-5 weeks and can be associated with arthritis or chicken poxB. pityriasis lichenoided Chronica(PLC)-eruotion of brownish papules with adherent scale that may persist for years TX: Erythromycin, Tetracycline, dapsone2. UV light A and B3. MTX, steroids and gold

Pityriasis Lichenoides is a benign, self-limited papulosquamous disease characterized by reddish brown papulonecrotic lesions. It is not a form of skin cancer, contagious viral infection, or an autoimmune disorder.

Explanation

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