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Psoriasis for Dummies Ramesh Mehay Programme Director (Bradford VTS)

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Presentation on theme: "Psoriasis for Dummies Ramesh Mehay Programme Director (Bradford VTS)"— Presentation transcript:

1 Psoriasis for Dummies Ramesh Mehay Programme Director (Bradford VTS)

2 This presentation will not concentrate on the aetiology/pathogenesis/epidemiology of psoriasis You can find all that in electronic text books Instead, we will concentrate on the practical side of things Things which most doctors have difficulty with

3 Types of Psoriasis Can you spot which types of psoriasis these are? Each PowerPoint slide has notes which tells you more about the condition if you want to know more But I suggest you dont spend too long here. Being able to recognise them and noting their specific key points is more important

4 Remember, with all these slides if you are having difficulty recognising what it is, go back to basics and describe to yourself what you SEE Are you ready?

5 First one...

6 Psoriasis Vulgaris Is a common psoriatic pattern you see Think: scalp, lumbosacral, elbows and knees Can you describe what the lesions look like?

7 Characteristically, they are 1.well-defined, raised, erythematous and scaly lesions, which are "salmon pink" or "full rich red" in colour 2.surface silvery scale which may be easily removed often leading to pin - point capillary bleeding (Auspitz sign) 3.they may or may not itch but this is not usually a prominent feature

8 Lets go a bit quicker

9 Number Two

10 How do you treat it? often erupts suddenly after an acute group B haemolytic streptococcal pharyngitis So, may need to give antibiotics Then wait and see May rapidly disappear or form stable plaques If stable plaques form: calcipotriol, high potency steroids, light therapy Tonsillectomy if recurrent sore throats with guttate flare ups?


12 And the third

13 Whats important about this type of psoriasis? It can be life threatening Esp: high output cardiac failure (so bell the lungs!) Thermoregulation problems, dehydration and septicaemia can result. (Admit them straightaway for methotrexate + cyclosporin Rx) One of the few dermatological emergencies.

14 Number Four

15 Why is this one important? Acute pustular psoriasis is a potentially life threatening disease Attacks may be precipitated by infection, drugs, pregnancy, or the withdrawal of topical or systemic corticosteroid therapy. The patient may present with a high, swinging fever of non -infective origin, but secondary infections may occur (and is potentially lethal). (Admit them straightaway for methotrexate + cyclosporin Rx) Another one of the few dermatological emergencies.

16 The Final Fifth

17 What do you do about it? Palmoplantar psoriasis is difficult to treat. Both hyperkeratosis and inflammation should be treated separately a keratolytic agent for hyperkeratosis calcipotriol or a moderately potent topical corticosteroid (e.g. betnovate-RD (R) ointment) may help. isotretinoin has also been used to treat pustular psoriasis acitretin or methotrexate may be needed in disabling palmoplantar psoriasis

18 Things that cause difficulty Unstable Psoriasis Psoriatic arthritis Scalp Psoriasis

19 General Treatment

20 Specific Treatment

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