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Skin in the Game
100

There are several scales for psoriasis assessment.  BSA is one example, what are two other examples?

Any two of the following:

PASI: Psoriasis area and severity index

PGA: Physician Global Assessment

PGA x BSA 

PSI: Psoriasis Symptom Inventory (PSI)

DLQI: Dermatology Life Quality Index 

Pruritus assessment E.g. Visual analog scale (VAS) and/or Numeric rating scale (NRS) – either one

 

100

Name one area of the body where high-potency corticosteroids should be avoided.


Any of the following:

  • Face
  • Intertriginous areas (skin folds) i.e. armpits, groin, under the breasts, genitals, between the buttocks
100

What percentage of patients with psoriasis meet criteria for moderate-to-severe disease requiring consideration of systemic therapy?


About 20%

100

Name three lifestyle and behavioural strategies that patients should be encouraged to adopt to help improve psoriasis.

Any three of the following:

  • Weight management (diet and exercise)
  • Smoking cessation
  • Stress management
  • Alcohol moderation or cessation
200

Name two ways that psoriasis presentation or treatment may differ in skin of colour.

Any two of the following:

  • Melanin may mask erythema
  • Lesions may appear purple, deep brown or grey
  • Plaques may be thicker
  • Hair texture, care patterns, hair washing frequency, head coverings and patient preferences should be considered when developing a management plan
  • Patients with Afro-textured hair may prefer foams and lotions to shampoo for scalp psoriasis
  • Early diagnosis and treatment needed to minimize post-inflammatory pigment alteration (hypo- or hyper-pigmentation)
  • May require longer treatment
200

Vitamin D supplementation should be avoided with which class of topical therapy?

Vitamin D analogues

200

**DAILY DOUBLE**

With which conventional systemic therapy do you need to avoid pregnancy and blood donation during therapy and for 3 years after?


Acitretin

200

**DAILY DOUBLE**

According to treat-to-target principles, which outcome ultimately supersedes formal disease activity targets?


Overall patient satisfaction

300

**DAILY DOUBLE**

When trying to achieve ideal MDA (minimal disease activity), what PGA score are we aiming for?


PGA ≤1

300

**DAILY DOUBLE**

Name 3 formulations that could be appropriate for scalp psoriasis.

Any 3 of the following:

  • Foam
  • Lotion
  • Solution
  • Shampoo
300

Which 6 body sites are considered “high-impact” regardless of BSA and therefore often drive escalation beyond topical therapy?


All 6 of the following (will accept palms/soles as 2): Face, scalp, genitals, palms, soles, nails

300

Which patient-reported outcome tool is most commonly used to assess psoriasis-related quality of life?


DLQI

400

**DAILY DOUBLE**

In general, super-potent corticosteroids should not be used daily for longer than ___ weeks 

-AND-

Potent corticosteroids should not be used for longer than __weeks without interruption regardless of plaque location.  

Super-potent 2 weeks and potent 6 weeks

400

**DAILY DOUBLE**

According to Delphi consensus data, approximately what proportion of psoriasis patients under-dose their topical therapy?


About 95%

400

Name 3 key patient counselling points with methotrexate.


Any 3 of the following:

  • Dose is weekly, not daily
  • Use reliable contraception
  • Advise alcohol abstinence
  • Ensure vaccinations are up to date (live vaccines contraindicated)
  • Rotate subcut injection site, use sharps container
  • Know early signs of infection
  • Taking with food, consuming with coffee/dark chocolate may help GI side effects
400

**DAILY DOUBLE**

More than half of psoriasis patients report difficulty with which two daily activities?

Physical exercise and sleep

500

Which of the following statements is TRUE regarding maintenance therapy approaches for topicals:

 

A. Proactive refers to preventative/intermittent treatment (i.e. Maintaining treatment 1 or 2 times per week to prevent flares)

B. Reactive refers to tapering (deintensification) & stopping treatment and then using on demand as needed for flares

C. Expert opinion states that the proactive approach can be used for all topical treatments

D. A & B

E. All of the above


E. All of the above

500

Which class of topical agents can cause flushing at the application area after ingesting alcohol?

Calcineurin inhibitors (will also accept individual names: pimecrolimus (Elidel) or tacrolimus (Protopic)

500

**DAILY DOUBLE**

List 3 situations in which biologics would be considered for psoriasis.

Any 3 of the following - conventional treatments:

  • Failed

  • Contraindicated

  • Not tolerated

  • Unlikely to result in treatment success

500

By how much does psoriasis shorten the average life span?

5 years