Psoriasis

Psoriasis

Psoriasis is one of the commonest skin disorders. Psoriasis is a chronic autoimmune skin disease. In auto immune disease immune system of our body attacks our own tissues, which leads to the rapid build-up of skin cells and causes scaling on the skin’s surface. Psoriasis may begin at any age, but most diagnoses occur in adulthood. The average age of onset is between 15 to 35 years old. According to the World Health Organization (WHO) some studies estimate that about 75 percent of psoriasis cases are diagnosed before age 46.

Definition

Psoriasis is an inflammatory and proliferative immune mediates disease of the skin that results in a rapid turnover of the skin cells.

Types

·              Plaque type Psoriasis

·              Guttate Psoriasis, Pustular Psoriasis

·              Inverse Psoriasis

·              Erythrodermic Psoriasis

·              Nail Psoriasis

·              Psoriasis of the Scalp

·              Palmar-Plantar Psoriasis

·              Psoriatic Arthritis

·              Systemic diseases in Psoriasis

Causes

The exact cause of psoriasis is not fully undestood.

Immune system: Autoimmune conditions are the result of the body cell reacting against its own cells.

Genetics: Approximately 35 to 50 percent of people genetically inherit the condition.

Triggers

Food: Whole milk, citrus fruits, gluten and fatty foods.

Drugs: Lithium, Non Steroidal Anti-Inflammatory Drugs (NSAIDs), malaria drugs, beta-blockers, tetracycline etc.

Weather: Excess sun exposure, Cold, dry weather

Infections

Others: Alcohol, Smoking, Stress, Obesity, Scratches, bites and Skin injury.

Risk Factors

·              Family history

·               Viral and bacterial infection

·              Stress

·              Obesity

·              Smoking

Signs and Symptoms

·              Red, raised, inflamed patches of skin

·              Whitish-silver scales or plaques on the red patches

·              Dry skin that may crack and bleed

·              Soreness around patches

·              Itching and burning sensations around patches

·              Thickened, pitted nails

·              Painful, swollen and stiff joints

Diagnosis

·              Nose specific blood test or diagnostic procedures

·              Physical Examination

·              Skin Biopsy or scraping

Management

Psoriasis has no cure. Treatments aim is

·              to reduce inflammation and scales

·              to slow the growth of skin cells

·               to remove plaques.

Topical treatments: Creams and ointments applied directly to the skin can be helpful for reducing mild to moderate psoriasis.

·              Steroid creams

·              Vitamin D3 creams

·              Phototherapy (ultra violet light).

·              Immune system suppressing medications.

·              Photo chemotherapy (PUEA).

Nursing Management

·               Assist patient with daily tub bath to soften scales and plaques.

·               Apply topical preparation after bath and scale removal.

·               Advise patient to wear goggles during phototherapy.

·              Encourage patient to follow up.

·              Encourage patient to try to identify triggers.

·              Teach patient to avoid direct sun exposure.

·              Advice patient to use good lubricants to prevent drying and cracking of skin.

Complications

·               Psoriatic arthritis

·              Obesity

·              Type 2 Diabetes

·              Hyper tension

·              Cardio Vascular disease

·              Parkinson’ Disease