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Psoriasis

Psoriasis is a chronic skin disease characterized by scaling and inflammation caused by an abnormal immune system that triggers excessive skin cell formation. Symptoms include raised red patches covered with silvery scales that appear on the trunk, limbs, scalp, elbows, knees and back. Treatment goals are to slow skin cell turnover and resolve lesions. Medical management includes topical corticosteroids, calcipotriene, tazarotene, methotrexate, and photochemotherapy. Nursing care focuses on health teaching, preventing skin injury from scratching, and keeping skin moisturized.

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Lau Colastre
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129 views4 pages

Psoriasis

Psoriasis is a chronic skin disease characterized by scaling and inflammation caused by an abnormal immune system that triggers excessive skin cell formation. Symptoms include raised red patches covered with silvery scales that appear on the trunk, limbs, scalp, elbows, knees and back. Treatment goals are to slow skin cell turnover and resolve lesions. Medical management includes topical corticosteroids, calcipotriene, tazarotene, methotrexate, and photochemotherapy. Nursing care focuses on health teaching, preventing skin injury from scratching, and keeping skin moisturized.

Uploaded by

Lau Colastre
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PSORIASIS

PSORIASIS

Definition:

- A chronic skin disease characterized by scaling and


inflammation. Scaling occurs when cells in the outer layer of
skin reproduce faster than normal and pile upon the skin’s
surface.
Immune System
- Normal immune system includes the T cells and WBC’s
- Abnormal Immune System
o Causes activity by T cells in the skin triggering inflammation and
excessive skin cell formation
o

CONTRIBUTING FACTORS:
- Periods of emotional stress and anxiety
- Trauma
- Infections
- Seasonal and hormonal changes
- Race – Caucasians
- Genetic predisposition
-

SYMPTOMS:
1. Lesions (red, raised, dry, pruritic patches with silvery scales) appear on
the trunk, limbs, scalp
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PSORIASIS

2. Vividly red plaques on the scalp, elbows and knees, lower part of the
back, genitalia and nails
3. Nails – pitting and discolored with crumbling beneath the free edges and
separation of the nail plates

MEDICAL MANAGEMENT
Goals:
⚫ Slow the rapid turnover of epidermis
⚫ Promote resolution of psoriatic lesions
⚫ Control the natural cycle of the disease
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PSORIASIS

1. Assessment of life & management of stress

2. Daily baths – may add olive oil or coal tar preparations (Balnetar) & use a
soft brush

3. Emolient creams w/ alpha-hydroxy acids (Lac-Hydrin, Penederm) or


salicylic acid

Pharmacologic Therapy
1. Topical corticosteroids – for 4 weeks or 2x daily
Considerations: 2-week break before repeating treatment w/ very potent agents;
occlusive dressing to increase absorption; highly-potent – not for large areas
affected ==> adrenal suppression
2. Topical Non-steroidal Treatment
- for large areas
- Calcipotriene (Dovonex) & Tazarotene (Tazorac) == suppress
epidermopoiesis
3. Oral Agents
- Methothrexate == inhibits DNA synthesis in epidermal cells reducing the
turnover time of psoriatic epidermis (toxic to liver, kidneys & bone
marrow)
4. Photochemotherapy
- photosensitizing oral medication + UV-A light
- decreases cellular proliferation
- for widespread psoriasis (50% of the body)

NURSING MANAGEMENT
1. Health teaching
- disease process
- skin care
- treatment regimen
2. Prevent skin injury
- don’t pick/scratch
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PSORIASIS

3. Prevent skin dryness


- emolients
- avoid excessive washing
- use warm (not hot) water
- pat dry
4. Use of therapeutic relationship for support & aid coping

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