What others manifestation could present a patient with Psoriasis?

Learning Goal: I’m working on a nursing discussion question and need a sample draft to help me learn.

250 word response- Formatted and cited in current APA style (with intext citation) include academic resource no more than 5 years old or current per question.

Question #1:

The biggest organ in the body, the skin serves a variety of purposes. Temperature control, absorption, defense against dangerous substances, and sensory reception are just a few of the functions that different processes play in maintaining homeostasis. However, the integumentary system is prone to several infections, diseases, and injuries. This essay examines two case studies of illnesses that affect the skin and its sensory region.

K.B., a 40-year-old woman, was identified five years ago as having restricted plaque-type psoriasis. Prior to experiencing an illness relapse, she had been undergoing therapy and was doing well. The elbows, legs, arms, knees, groin, and scalp regions have seen most of the current condition’s manifestations.

Name the most common triggers for psoriasis and explain the different clinical types.

Red patches and elevated lesions are the hallmarks of the non-contagious papulosquamous condition known as psoriasis. The precise cause of psoriasis is still unknown (Kim et al., 2017). Psoriasis, however, begins because of many immune system triggers. They consist of physical harm to the skin, stress, underlying disorders, allergies, and environmental factors. Plague, inverted, guttate, pustular, and erythrodermic psoriasis are some of the numerous kinds of psoriasis (Rendon et al.,2019). Depending on the type of disease, the symptoms of the ailment vary greatly. The most typical form of the condition is plaque psoriasis.

There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.

Psoriasis is a chronic, recurring condition that frequently requires long-term treatment. The severity of the condition, any coexisting conditions, and availability of medical care all influence the treatment option for psoriasis. According to the clinical severity of the lesions, the proportion of the body’s surface area that is affected, and the quality of life of the patient, psoriatic patients are generally divided into two groups: mild or moderate to severe psoriasis. The use of glucocorticoids, vitamin D analogues, and phototherapy in combination can be used to treat mild to moderate psoriasis topically. Treatment options for systemic psoriasis are frequently needed. Comorbidities such psoriasis arthritis are also very important when choosing a course of treatment. (Mrowietz et al., 2011). To inhibit rapid skin cell development and improve discomfort, a variety of therapeutic options can be used. They consist of pharmaceuticals and recreational drugs as well as medical procedures like photodynamic treatment. Topical creams, steroids, anti-inflammatory, and immunosuppressive drug delivery are additional medicinal treatments for psoriasis. Moisturizers, UV light therapy, and petrolatum application are examples of lifestyle pharmaceuticals. Methotrexate and cyclosporine drug delivery would be the best course of treatment for K.B. Plaque psoriasis can potentially benefit from the addition of light therapy to the medicine.

A medication review and reconciliation are always important in all patients, describe and specify why in this case is important to know what medications the patient is taking.

Medical reviews are essential for the treatment of psoriasis and help to avoid the disease’s side effects. Knowing a patient’s medicine helps the doctor manage side effects, treat psoriasis more effectively, and use fewer additional drugs to cut costs (Kim et al., 2017). The task of managing drugs is split evenly between the patient and his or her healthcare professional. While the doctor must write prescriptions and educate the patient, it is ultimately the patient’s responsibility to heed the doctor’s advice.

What others manifestation could present a patient with Psoriasis?

Psoriatic arthritis (PsA), Crohn’s disease (CD), psychological/psychiatric problems (DPP), and uveitis are comorbidities that are traditionally linked to psoriasis. The metabolic syndrome as a whole and each of its distinct elements have recently been linked to psoriasis. The most typical psoriasis symptoms are red patches, itchy skin, thickened skin, nails, and cracked skin. Swollen and stiff joints, difficulty moving or doing chores, obesity, autoimmune disorders such celiac disease, and high blood pressure are additional severe disease manifestations. Since psoriasis is an autoimmune disease, having it can increase your risk of getting other autoimmune diseases these include lupus, and multiple sclerosis (MS) (Mrowietz et al., 2011).

Case Study #2

Based on the clinical manifestations presented in the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.

From the symptoms presented, the patient has conjunctivitis. The disease is characterized by red or pink eye as presented by the patient (Ameeduzzafar et al., 2018). Redness of the eyes indicates the inflammation of the transparent membrane lining the eyelids and the eyeball. Conjunctivitis is also characterized by a yellowish discharge that forms a crust on the eyelashes in the morning. The presence of yellow eye discharge suggests that bacteria are to blame for conjunctivitis. The patient claims that after being cleansed away, the yellow discharge returns, which is a sign of contagious germs. The pathogens Streptococcus pneumonia and Staphylococcus aureus are linked to bacterial conjunctivitis. Typically, bacterial conjunctivitis and ear infections coexist (Bhat et al., 2021).

With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

Most conjunctivitis-causing viruses are communicated through hand-to-eye contact with infected hands or objects. Hands can get contaminated if they come into touch with infected tears, eye fluid, feces, or respiratory discharges. Bacterial conjunctivitis can be treated using a variety of drugs and therapy techniques. To combat the bacterial infection, the patient needs to have IV ceftriaxone along with topical antibiotic therapy (Bhat et al., 2021).

Based on your answer to the previous question regarding the etiology of eye affection, which would be the best therapeutic approach to C.J problem.

Antibiotics shorten the duration of an infection and stop the sickness from spreading to other people. The patient is advised to have comprehensive anterior exams every day till the bacterial conjunctivitis has cleaned up. Even though bacterial conjunctivitis typically resolves on its own, studies have indicated that topical ophthalmic medicines can be helpful. Over the past few decades, bacterial resistance to all kinds of optical antibiotics has been progressively rising. The most effective choice for treating bacterial conjunctivitis is still fluoroquinolones (Ameeduzzafar et al., 2018).

Question #2

Name the most common triggers for Psoriasis and explain the different clinical types.

There are various triggers of Psoriasis, including skin infections and strep throat infections, weather, especially during dry and cold seasons, and skin injuries such as scrapes or cuts, severe sunburn, or bug bites. Other triggers are exposure to smoking or second-hand smoke, heavy consumption of alcohol, and certain medications such as high blood pressure medications, lithium, and antimalarial drugs. Rapid withdrawal of systemic or oral corticosteroids triggers Psoriasis because it flares up and worsens the condition (McCance & Huether, 2018).

There are several treatments for Psoriasis; explain the different types and indicate the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.

Psoriasis treatments can either be phototherapy, topical, or injection. Phototherapy is a nonpharmacological treatment involving periods of exposure to direct sunlight or a particular UVB light type. This therapy aims to expose the skin to as much light as possible, slow skin cell growth, and ease symptoms (Tagliaferri et al., 2019). Topical treatment involves the application of medication on the mucous membrane or skin and allowing it to enter it from there. It nourishes the skin, protects it from harm, and helps ease body pains. Injection, on the other hand, is highly recommended for people with Psoriasis and who have not improved after taking other treatments or when the alternatives are exhausted. The best-recommended type of treatment is topical treatment (Dlugasch & Story, 2019).

Pharmacological and non-pharmacological options

Pharmacological treatments for psoriasis are corticosteroids, the most frequently preferred medication for treating both mild and moderate Psoriasis. Vitamin D analogs help in slowing down the growth of skin cells. Calcineurin inhibitors reduce plaque build-up and inflammation, and coal tar reduces itching, scaling, and inflammation. The best recommended topical treatment to treat this relapse is corticosteroid treatment (Dlugasch & Story, 2019). Methotrexate can also be administered, usually weekly as a single oral dose, to decrease the production of skin cells and suppress inflammation (Tagliaferri et al., 2019). As stated above, light therapy is the nonpharmacological treatment for spreading and reducing symptoms of psoriasis.

A medication review and reconciliation are always critical in all patients; describing and specifying why, in this particular case, is important to know what medications the patient is taking.

Since there are many drug-to-drug interactions, it is essential to ensure that the patient’s list of other medications is known, which can help determine the best and most harmless treatment. Also, identifying the patients’ medications can help to know which drugs have been tried, how effective they were, and how the patient responded to them. A patient might be given the same medication they once tried, which never worked; thus, no positive outcomes will be experienced.

What other manifestations could present a patient with Psoriasis?

Other manifestations that could present in a patient with psoriasis can differ in how the skin lesions present themselves, including erythrodermic, inverse, guttate, and pustular. Erythrodermic is a rare skin condition that causes a red rash to form over a more significant part of the skin; since a large part of the skin is affected, it puts a patient at risk of infections and electrolyte abnormalities (McCance & Huether, 2018). Typically, the red rash is severe as it causes dehydration, fever, and chills. This is an extreme manifestation of psoriasis that requires immediate medical attention. Correspondingly, guttate psoriasis is characterized by small, pink-red papules and plaques that might appear on the legs or arms; this condition is a rare manifestation of psoriasis (McCance & Huether, 2018). With inverse psoriasis, there is a rash on the part of the body where the skin rubs against itself.

Moreover, pustular psoriasis is manifested by yellowish pustules on an erythematous base. This condition is linked with infectious signs such as fever and malaise. Other manifestations may include aching or joint pain, nail change (yellow-brown spots or thickening), and comorbid diseases such as hypertension or cardiovascular disease (Dlugasch & Story, 2019).

Sensory Function Case Study

Based on the clinical manifestations presented in the case above, which would be your eye diagnosis for C.J. Please name why you got to this diagnosis and document your rationale.

The diagnosis for C.J. is bacteria conjunctivitis, an infection that affects the eye mucous membrane called the conjunctiva that extends from the back side of the eyelid surface. From there, it goes into the fornices, and then the globe, called bulbar conjunctiva, then at the end, fuses with the cornea located at the limbus. Common signs and symptoms that confirm the diagnosis are bilateral conjunctival erythema and yellowish discharge (Azari & Arabi, 2020).

With no further information, would you be able to name the probable etiology of the eye infection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

It is possible to identify the etiology of the eye infection without being provided with further information since, from the symptom of yellowish discharge, one can tell that it’s a bacterial infection. The bacteria might have spread from the hands to the eye via direct contact. A pinkish discharge may be due to a viral infection resulting from irritation (McCance & Huether, 2018).

Based on your answer to the previous question regarding the etiology of eye affection, which would be the best therapeutic approach to C. J’s problem?

The best therapeutic option for this patient is to advise them to improve their hygiene which they can achieve through proper hand washing and staying away from work for one to three days until the infection is eliminated. Also, the patients can use supportive therapy that involves cool compresses and artificial tears at least six times a day. A physician can also recommend antibiotics for the patients to help eliminate the bacteria (Tagliaferri et al., 2019).