Term
| pathogenic process of psoriasis |
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Definition
| hyperproliferation & accelerated maturation of epidermal keratinocytes; accumulation in lesions; incomplete differentiation of keratinocytes; abnormal adherence & scaling; abnormal growth & dilation of superficial BVs; redness of lesions; inflammatory infiltrates |
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Term
| Risk Factors for Developing Psoriasis |
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Definition
| Meds (lithium, NSAIDs, ACEIs, tetracyclines), trauma & stress, infections, winter months, smoking, obesity & higher BMI, alcohol consumption |
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Term
| Associated Conditions with Psoriasis |
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Definition
| psoriatic arthritis; increased risk of cardiovascular disease; higher incidence of Irritable Bowel Disease; multiple sclerosis; malignancies; depression |
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Term
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Definition
| most common form (80-90%); usually asymptomatic, often pruritic & painful plaques; coin-sized to palm-sized plaques; present for months to years |
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Term
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Definition
| small, "drop-like" lesions; often precedes strep throat/pharyngitis; acute eruption in child or young adult with no previous history |
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Term
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Definition
| no visible scaling; often misdiagnosed as fungal or bacterial infection |
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Term
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Definition
| most inflammatory form - intense reddening, severe pruritus, & pain; may require hospitalization due to complications (dehydration, infection) |
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Term
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Definition
| most severe form - marked inflammation leads to acute onset; may require hospitalization due to complications - hepatic abnormalities |
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Term
| Affects of Psoriasis on Nails |
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Definition
| affected in ALL forms of psoriasis; pitting, loosening, & white areas under plate |
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Term
| Topical Therapy Options in Psoriasis |
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Definition
| 1st line: salicylic acid, corticosteroids, Vit D analogues, tazoratene; 2nd line agents: coal tar, anthralin; emollients/moisturizers, balneotherapy |
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Term
| emollients/moisturizers [Eucerin, Vaseline] |
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Definition
| used to minimize dryness during treatment-free periods; use 4-6 times daily |
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Term
| balneotherapy [SAPROX clay, Healing Botanicals Therapeutic Bath] |
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Definition
| bathing in waters containing certain salts that reduce activated T-cells |
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Term
| salicylic acid OTC [Neutrogena T/Sal Therapeutic Shampoo, OxyClean soaps] |
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Definition
| MoA: disruption of keratinocytes in psoriatic skin; monitor for poisoning: N/V, tinnitus, & hyperventilation; do not use in combo with UV phototherapy or Vit D analogs |
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Term
| Class I steroids: clobetasol propionate 0.05%, halobetasol propionate |
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Definition
| corticosteroids used primarily as alternatives to systemic adrenocorticoid therapy; most potent antiproliferative, immunosuppressive, & vasoconstrictive properties; treat thick, chronic, resistant psoriatic plaques; use for as short of time (MAX OF 2 WKS!!) as possible & on small areas of body |
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Term
| Class VII steroids: hydrocortisone 1%, methylprednisolone |
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Definition
| safest corticosteroid for long-term application for use on face & intertriginous areas, in infants, & in young children |
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Term
| ADRs of topical corticosteroids |
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Definition
| cutaneous - skin atrophy, stretch marks, folliculitis, purpurs; systemic - Cushing's syndrome, cataracts, & glaucoma |
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Term
| Vit D Analogues - calcipotriene (Dovonex), calitriol (Vectical) |
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Definition
| Indications: plaque psoriasis & psoriasis of scalp; Apply to affected area once or twice daily for up to 8 weeks |
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Term
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Definition
| topical retinoid (gel or cream); Apply once in evening; ADRs: cutaneous irritation (cream is less so); Pregnancy Category X |
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Term
| coal tar [T-Gel, Denorex, Tegrin Shampoos, MG 217 Ointment] |
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Definition
| cystostatic agent that reduce scales; used in combo with UV light; ADRs: folliculitis, stains skin, photosensitivity, strong odor |
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Term
| anthralin [Dithocreme, Drithro-Scalp] |
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Definition
| treats mild-moderate psoriasis & refractory scalp psoriasis; works best in combo with UV light for chronic plaque-type & guttate psoriasis; Dosing: apply overnight for only up to 60 min; ADRs: skin staining, disappears in 1-2 wks after discontinuation |
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Term
| Ultraviolet (UVB or UVA) Phototerapy |
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Definition
| beneficial for control of psoriatic skin lesions; acts via antiproliferative (slowing keratinization) & anti-inflammatory effects (apoptosis of pathogenic T-cells); ADRs: accelerated photo damage, cutaneous malignancy |
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Term
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Definition
| phototherapy used in combo with psoralen |
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Term
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Definition
| phototherapy most commonly used for moderate to severe psoriasis |
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Term
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Definition
| 1st line: biologic therapy; 2nd line: acitretin, cyclosporine, methotrexate, mycophenolate, sulfasalazine, 6-thioguanine, hydroxyurea |
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Term
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Definition
| first-line systemic therapy; MoA: inhibits TNF-alpha, a cytokine that plays a role in inflammation; Treats mild-moderate plaque psoriasis & psoriatic arthritis; Dosing: Subcutaneous twice a wk; ADRs: respiratory & GI tract infections, abdominal pain, N/V |
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Term
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Definition
| MoA: T-cell activation inhibitor; Indications: moderate to severe psoriasis & psoriatic arthritis; significant clinical response seen after 3 months; long-lasting improvements; Dosing: IM once weekly for 12 wks; ADRs: pharyngitis, flu-like symptoms, injection site pain/inflammation |
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Term
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Definition
| only oral retinoid; Indications: severe psoriasis; works on lesions slowly: long-term use is safe! ADRs: hypervitaminosis A, hepatotoxicity, hypercholesterolemia, hypertriglyceridemia; Pregnancy Cat. X |
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Term
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Definition
| immunosuppressant, systemic calcineurin inhibitor; Indications: both cutaneous & arthritic psoriasis; ADRs: HTN, hyperkalemia, nephrotoxicity, gingival hyperplasia; Use for >2 yrs --> increase in malignancy; To prevent nephrotoxicity, use dose < 5 mg/kg/day & treat for <1 yr |
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Term
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Definition
| folate antimetabolite; T & B-cell inhibitor & suppressor of various cytokines secretion; Indications: moderate to severe psoriasis, particularly beneficial for psoriatic arthritis; ADRs: N/V, ulceration, stomatitis, PULMONARY TOXICITY, BONE MARROW TOXICITY; Preg. Cat. X; IMPORTANT: DO NOT ABRUPTLY D/C drug |
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Term
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Definition
| macrolide immunosuppressive agent; Indications: severe recalcitrant psoriasis; Other uses: prevention of organ transplant rejection; ADRs: diarrhea, nephrotoxicity, paresthesias |
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Term
| Pharmacist's Role in Treating Pts with Psoriasis |
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Definition
| promote improved disease management (use of OTCs, environmental factors, pt's med records); improve use of topical meds (selecting appropriate vehicles, dosing); improve adherence; monitor for treatment-related complications |
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Term
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Definition
| excessive scaling of scalp due to accelerated epidermal cell turnover, may be result of elevated levels of yeast-like fungus normally found on scalp; found in areas with many sebaceous glands; Clinical Manifestations: white/gray dry or oil scales, pruritus; Triggers: increased stress, fatigue, weather extremes, oily skin, infrequent shampoos, obesity |
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Term
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Definition
| more excessive inflammation & increased epidermal cell turnover rate than dandruff, affects scalp, face, & trunk with dense distribution of sebaceous glands; greasy, yellowish scales on erythematous patches that are itchy; white dandruff --> oozing & thick crusting; improves in warmer months, exacerbates in colder months; peaks during infancy & again in adult years |
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Term
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Definition
| chronic dermatological disorder involving hair loss from anywhere on body, often on scalp |
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Term
| Common causes of alopecia |
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Definition
| family history, mental disorders, stress, infections, autoimmune diseases, cancer, chemotherapy, endocrine system disorders |
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Term
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Definition
| hair loss begins at temples or vertex & spreads to diffuse thinning or nearly complete hair loss |
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Term
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Definition
| hair thinning in frontal, parietal, & crown regions |
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Term
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Definition
| most common form of male-pattern & female-pattern baldness |
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Term
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Definition
| OTC product; Indication: male/female pattern hair loss; MoA: prolongs anagen phase & follicles to achieve mature growth; indefinite treatment to maintain regrowth; ADRs: skin irritation, contact dermatitis, incresed facial hair; Counseling Pts: 1) use continuously for a minimum of 12 months, 2) apply to apex of scalp |
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Term
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Definition
| Rx; 5-alpha reductase inhibitor --> inhibits DHT formation; Indications: ONLY MALE pattern hair loss; indefinite treatment to maintain follicular regrowth; ADRs: decreased libido, erectile dysfunction, gynecomastia, myopathy; Counseling Pts: 1) Use continuously for 12 months, 2) PSA levels were decreased in elderly --> prostate screenings required |
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