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\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
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%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{Naseiwa (Nasiewa)}
\pdfinfo{
  /Title (psoriasis.pdf)
  /Creator (Cheatography)
  /Author (Naseiwa (Nasiewa))
  /Subject (Psoriasis Cheat Sheet)
}

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% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Psoriasis Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Naseiwa (Nasiewa)} via \textcolor{DarkBackground}{\uline{cheatography.com/127057/cs/24696/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Naseiwa (Nasiewa) \\
  \uline{cheatography.com/nasiewa} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 7th October, 2020.\\
   Updated 7th October, 2020.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.

\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{What is psoriasis?}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Autoimmune chronic inflammatory diseases of the skin.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Occurs due to overstimulation of immune cells that causes excessive proliferation of keratinocytes.} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Silvery scaling of skin and itching.} \tn 
% Row Count 5 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Not contagious and not severe in many cases (outpatient mx)} \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{General features}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Erythematous papules and silvery-white scaling plaques} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Well demarcated, raised, red patches} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Usually not itchy (pruritus is typically mild - 80\% of cases)} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Affects scalp, back, elbows and knees (extensor surfaces), and nails (thimble pitting).} \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Erythematous}}- superficial redness caused by dilation of capillaries.  \newline {\bf{Nail pitting }}- small, round depression in the nail.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.94103 cm} x{3.03597 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Clinical variants.}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Plaque psoriasis}} & Well demarcated individual thick, scaly, erythematous lesions \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
{\bf{Guttate psoriasis}} & numerous small, scaly, red or pink, tear-drop shaped lesions \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Psoriatic nail disease}}} \tn 
% Row Count 7 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Drug-induces psoriasis}}} \tn 
% Row Count 8 (+ 1)
% Row 4
\SetRowColor{LightBackground}
{\bf{Psoriatic arthritis}} & Inflammation of joints on hand, feet and spine that can occur with psoriasis \tn 
% Row Count 12 (+ 4)
% Row 5
\SetRowColor{white}
Pustular psoriasis & appears as red bumps filled with noninfectious pus (pustules) \tn 
% Row Count 15 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\seqsplit{Flexural/inverse} psoriasis & occurs in skin folds and flexor surfaces creases of joints \tn 
% Row Count 18 (+ 3)
% Row 7
\SetRowColor{white}
Erythodermic psoriasis & generalized erythematous lesions. \tn 
% Row Count 20 (+ 2)
% Row 8
\SetRowColor{LightBackground}
Scalp psoriasis & affects the scalp \tn 
% Row Count 21 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.24425 cm} x{3.73275 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Plaque Psoriasis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Most common type} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Thick, scaly, erythematous lesions} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Lesions are red with silver-white scaling} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
Common sites: & Extensor surfaces of elbows and knees. \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
 & Lower back \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
 & Scalp (can cause temporary hair loss) \tn 
% Row Count 8 (+ 2)
% Row 6
\SetRowColor{LightBackground}
 & Palms \tn 
% Row Count 9 (+ 1)
% Row 7
\SetRowColor{white}
 & Nails- pitting and onycholysis \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Onycholysis}} - separation of the nail from the nail bed}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Guttate Psoriasis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Often preceded by Streptococcal infection ({\emph{Streptococcus pharyngitis}})} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Resolves quickly} \tn 
% Row Count 3 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Erythrodermic Psoriasis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{There is increase in cutaneous blood flow, heat loss, and water loss} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Skin becomes red.} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Scaling is absent (although this can proceed the erythroderma).} \tn 
% Row Count 5 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.24425 cm} x{3.73275 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Inverse/Flexural Psoriasis}}  \tn
% Row 0
\SetRowColor{LightBackground}
Common sites: & Genitals (between thigh and groin) \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
 & Armpits \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
 & Under an overweight abdomen (panniculus) \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
 & Under the breasts (inflammatory fold) \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Increased by friction and sweat} \tn 
% Row Count 8 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Vulnerable to fungal infections} \tn 
% Row Count 9 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Looks like smooth inflamed patches on skin} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.33919 cm} x{2.63781 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Psoriatic arthritis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Joint and Connective tissue inflammation.} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Most common joints affected: & Fingers and toes \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Results in Dacylitis} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
Other joints: & Knees, hips, spine (spondylitis) \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Morning stiffness of affected joints} \tn 
% Row Count 7 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Dacylitis}} - Sausage shaped swelling of fingers and toes.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{3.13551 cm} x{1.84149 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Pustular psoriasis}}  \tn
% Row 0
\SetRowColor{LightBackground}
Can be localized, common to hands and feet & Palmoplantar pustulosis \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Or generalized, widespread patches} \tn 
% Row Count 3 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.24425 cm} x{3.73275 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Etiology}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Genetics} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Precipitating factors} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
1. \seqsplit{Infections} & Pharyngitis, HIV \tn 
% Row Count 4 (+ 2)
% Row 3
\SetRowColor{white}
2. Drugs & Beta blockers, anti-malarial, lithium, NSAIDs, systemic steroid withdrawal \tn 
% Row Count 7 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{3. Alcohol and smoking} \tn 
% Row Count 8 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{4. Emotional stress} \tn 
% Row Count 9 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{5. Local trauma} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.18988 cm} x{2.78712 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Grading}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Mild (3\% of the body)} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Moderate (3-10\% of the body)} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Severe} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
Degree of severity is based on: & proportion of body surface area affected \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
 & disease activity (plaque, redness, scaling) \tn 
% Row Count 7 (+ 2)
% Row 5
\SetRowColor{white}
 & response to previous treatments \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
 & impact of the disease in the patient \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.14471 cm} x{3.83229 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Diagnosis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Based on appearance of the skin} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Skin biopsy, or scrapping - to rule out other disorders} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Biopsy shows clubbed rete pegs if positive for psoriasis} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
Auspitz sign & small pinpoint bleeding when scales are scraped off \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.89126 cm} x{3.08574 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Treatment}}  \tn
% Row 0
\SetRowColor{LightBackground}
Mild disease & Emolients \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\seqsplit{Mild-to-moderate} disease & {\bf{Topical corticosteroids}} (triamcinolone, fluocinonide, clobetasol), {\bf{emollients}}, {\bf{topical retinoids}} (tazarotene), {\bf{vitamin D analogs}} (calcipotriene, calcitriol) \tn 
% Row Count 9 (+ 8)
% Row 2
\SetRowColor{LightBackground}
For facial areas & Topical {\bf{tacrolimus}} and {\bf{Pimecrolimus}} \tn 
% Row Count 11 (+ 2)
% Row 3
\SetRowColor{white}
Severe & Phototherapy, MTX, cyclosporine, anti-T cell agent, anti-TNF agent \tn 
% Row Count 14 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Vitamin D analogs}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Avoid use on delicate skin areas (face, flexures) because of irritation.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Combine with steroids to increase efficiency} \tn 
% Row Count 3 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Coal Tar}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Anti-inflammatory, anti-pruritic, anti-mitotic} \tn 
% Row Count 1 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.14471 cm} x{3.83229 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Systemic Therapies}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{For severe generalized psoriasis intolerant after topical therapy} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
MTX & S/E: hepatic fibrosis, myelosuppression, teratogenic \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Hydroxyurea} & S/E: myelosuppression, skin reactions, liver toxicity, teratogenic \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\seqsplit{Cyclosporine} & S/E: renal toxicity, HTN, gingival hypertrophy \tn 
% Row Count 9 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}