Derm: Chronic plaque psoriasis: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Chronic Plaque Psoriasis🎧 A clear, high-yield breakdown of this autoimmune skin condition with red scaly plaques – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• A chronic autoimmune skin disorder marked by well-defined, erythematous plaques with silvery scales.• Most common form of psoriasis – also called psoriasis vulgaris.📌 Causes & Risk Factors• Genetic predisposition – often familial• Environmental triggers: stress, infections (e.g. strep throat), injury (Koebner’s phenomenon)• Drugs: beta-blockers, lithium, NSAIDs, antimalarials• Lifestyle: obesity, smoking, alcohol use🧠 Mnemonic: “SOAP BIL” – Stress, Obesity, Alcohol, Psoriasis genes, Beta-blockers, Infections, Lithium📌 Pathophysiology• Immune dysfunction → T-cell activation• Cytokines (e.g. IL-17, TNF-α) → stimulate keratinocyte hyperproliferation• Skin turnover accelerates (days vs weeks) → build-up of immature skin cells and plaques📌 Symptoms• Red, raised plaques with silvery scales• Commonly on extensor surfaces (elbows, knees), scalp, lower back• Nail changes: pitting, onycholysis, subungual hyperkeratosis• Itching, pain, fissuring🧠 Auspitz sign: pinpoint bleeding when scales removed🧠 Koebner phenomenon: new lesions at trauma sites📌 Differential Diagnosis• Eczema (less well-defined)• Tinea corporis (central clearing)• Bowen’s disease• Pityriasis rosea• Seborrhoeic dermatitis• Discoid lupus• Drug eruptions• Secondary syphilis• Cutaneous T-cell lymphoma📌 Diagnosis• Clinical diagnosis based on classic appearance + distribution• Biopsy if atypical or diagnostic uncertainty• No routine bloods required unless assessing for systemic therapy• Consider screening for psoriatic arthritis (joint symptoms)📌 Management• Stepwise approach depending on severityTopical (first line for mild-moderate):• Potent corticosteroids + vitamin D analogues• Emollients (key in all cases)• Tar preparations, tazarotene, dithranol (less common)Phototherapy (moderate-severe):• Narrowband UVB• PUVA (psoralen + UVA) for resistant casesSystemic therapy (severe/refractory):• Methotrexate, ciclosporin, acitretin, dimethyl fumarate• Biologics: adalimumab, ustekinumab, etanercept (for resistant or high-impact disease)General care:• Lifestyle support: smoking cessation, weight loss• Psychosocial support: address anxiety, depression• Screen for CV risk and psoriatic arthritis• Refer if severe, diagnostic doubt, treatment failure, or nail/facial/genital involvement📌 Complications• Psoriatic arthritis (up to 30%)• Cardiovascular disease, metabolic syndrome• Psychological effects: anxiety, depression• Flare with systemic steroids withdrawal• Treatment side effects (e.g. liver/kidney issues, skin cancer from phototherapy)📌 Prognosis• Chronic and relapsing-remitting• Early onset or strong family history = more severe course• Aim is symptom control, minimising flares, and maintaining quality of life📎 More MSRA Resources for Chronic Plaque Psoriasis📝 Revision Notes:https://www.passthemsra.com/topic/chronic-plaque-psoriasis-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/chronic-plaque-psoriasis-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/chronic-plaque-psoriasis-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/chronic-plaque-psoriasis-rapid-quiz/🎓 Full Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/📣 All resources are part of the Dermatology for the MSRA course athttps://www.passthemsra.com – your complete high-yield revision hub for exams and beyond 🧠💼Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #ChronicPlaquePsoriasis #Psoriasis #Dermatology #PsoriaticArthritis