PSORIASIS

PSORIASIS
This is an autoimmune skin disease that causes a rash with

itchy, scaly patches, most commonly on the knees, elbows, trunk and
scalp. It is a common, long term disease with no cure.
TYPES OF PSORIASIS
1. Plague Psoriasis: It is the most common type of psoriasis. It
causes dry, itchy, raised skin patches covered with scales. They
usually appear on the elbows, knees, lower back and scalp.
2. Nail Psoriasis: Can affect fingernails and toenails, causing pitting,
abnormal nail growth and discoloration.
3. Guttate Psoriasis: Primarily affects young adults and children. It
is usually triggered by a bacterial infection such as strep throat. It
is marked by small, drop shaped, scaling spots on the trunk, arms
and legs.
4. Inverse Psoriasis: Mainly affects the skin folds on the groin
buttocks and breasts. It causes smooth patches of inflamed skin
that worsen with friction and sweating. Fungal infection may
trigger this type of psoriasis.
PATHOPHYSIOLOGY
T-cells normally travel through the body to detect and fight
invading germs, such as bacteria. In people with psoriasis, they
start to attack healthy skin cells by mistake. This causes the
deepest layer of the skin to produce new skin cells more quickly
than usual, triggering the immune system to produce more T-cells.
RISK FACTORS
 Stress: It can cause an outbreak or exacerbate an existing cause.
 Skin Injury: Psoriasis can appear on areas of the skin where
vaccinations, sunburns, scratches or other injuries have occurred.
 Medications: i.e. Lithium makes psoriasis worse in about half of
the people who have it; Antimalarial cause psoriasis flare ups
typically 2-3wks after on starts taking the medication.
 Family history: Having a parent with psoriasis increases the risk
of developing it and having two parents with it increases it even
more.
 Race: People with fairer complexions are typically more likely to
develop psoriasis than people with darker complexion.
 Obesity: Friction and sweating that occurs deep in skin folds of
people with excess weight can lead to or aggravate psoriasis.
 Cold Temperature: People with psoriasis who live in colder
climates know that winter makes symptoms worse. The extreme,
cold and dryness of certain weather will pull moisture from the
skin, inflaming symptoms.
CAUSES
The cause psoriasis isn’t fully understood. It is thought to be
an immune system problem where infection fighting cells attack healthy
skin cells by mistake.
SIGNS AND SYMPTOMS

 A patchy rash that varies widely in how it looks from person to
person, ranging from spots of dandruff like scaling to major
eruptions over much of the body.
 Rashes that vary in color, tending to be shades of purple with gray
scale on brown or black skin and pink or red with silver scale on
white skin.
 Small scaling spots (commonly seen in children).
 Dry, cracked skin that may bleed.
DIAGNOSIS
 History taking
 Physical Exam: Especially on the skin, scalp and nails.
 Skin Biopsy: To determine the type of psoriasis and rule out other
disorders.
THERAPEUTIC MANAGEMENT
 Corticosteroids: Used to treat mild to moderate psoriasis.
 Vitamin D analogues i.e. Calcitriol: used alone or with topical
corticosteroids.
 Methotrexate: Usually administered as a single dose. It decreases
the production of skin cells and suppresses inflammation.
 Cyclosporine: Taken orally. It suppresses the immune system. It is
similar to methotrexate in effectiveness but cannot be used
continuously for more than a yr.
NURSING MANAGEMENT
 Examine skin condition
 Instruct patient not to pinch or scratch the skin area
 Keep the infected area clean and dry.
 Administer prescribed medication.
 Reduce the formation of scales with the provision of bath oil.
 Motivate patient to consume diet high in calories and high in
protein.
 Provide client and family teaching.
 Assess skin color changes.
 Examine for signs of infection.
PREVENTION
 Wrap up during the cold weather
 Keep the skin moisturized: dryness can trigger flare ups and make
skin scaling so severe that the skin cracks and bleeds.
 Keep the scalp moisturized
 Use a humidifier as it helps moisturize the skin and reduce
psoriasis symptoms.
 Get regular sun exposure.
 Reduce Stress

PSORIASIS

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PSORIASIS

This is an autoimmune skin disease that causes a rash with

SIGNS AND SYMPTOMS

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