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    Psoriasis

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    Ramalakshmi Lakshmi
    Psoriasis is a chronic skin disease that results in thick, red patches of skin covered with silvery scales, most commonly occurring on the elbows, knees, scalp, lower back, face, palms and feet. It occurs when skin cell production increases rapidly from the typical rate of 28-30 days to just 3-4 days. Risk factors include stress, smoking, and skin injuries. Treatment includes topical corticosteroids, vitamin D analogues, coal tar, and systemic therapies like methotrexate and cyclosporine. Nursing management focuses on moisturizing, protecting affected areas, advising lifestyle changes, and assisting with medication application.

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    Psoriasis

    Uploaded by

    Ramalakshmi Lakshmi
    4 views21 pages
    Psoriasis is a chronic skin disease that results in thick, red patches of skin covered with silvery scales, most commonly occurring on the elbows, knees, scalp, lower back, face, palms and feet. It occurs when skin cell production increases rapidly from the typical rate of 28-30 days to just 3-4 days. Risk factors include stress, smoking, and skin injuries. Treatment includes topical corticosteroids, vitamin D analogues, coal tar, and systemic therapies like methotrexate and cyclosporine. Nursing management focuses on moisturizing, protecting affected areas, advising lifestyle changes, and assisting with medication application.

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    Medical surgical nursing... integumentary system.. psoriasis

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    psoriasis

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    Psoriasis is a chronic skin disease that results in thick, red patches of skin covered with silvery scales, most commonly occurring on the elbows, knees, scalp, lower back, face, palms and feet. It occurs when skin cell production increases rapidly from the typical rate of 28-30 days to just 3-4 days. Risk factors include stress, smoking, and skin injuries. Treatment includes topical corticosteroids, vitamin D analogues, coal tar, and systemic therapies like methotrexate and cyclosporine. Nursing management focuses on moisturizing, protecting affected areas, advising lifestyle changes, and assisting with medication application.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4 views21 pages

    Psoriasis

    Uploaded by

    Ramalakshmi Lakshmi
    Psoriasis is a chronic skin disease that results in thick, red patches of skin covered with silvery scales, most commonly occurring on the elbows, knees, scalp, lower back, face, palms and feet. It occurs when skin cell production increases rapidly from the typical rate of 28-30 days to just 3-4 days. Risk factors include stress, smoking, and skin injuries. Treatment includes topical corticosteroids, vitamin D analogues, coal tar, and systemic therapies like methotrexate and cyclosporine. Nursing management focuses on moisturizing, protecting affected areas, advising lifestyle changes, and assisting with medication application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 21

    PSORIASIS

    INTRODUCTION

    Psoriasis is a chronic skin disease result in patches of thick red skin


    Covered with the silveryscales.These patches are referred as plaque
    Which usually occurs on the elbow, knees,legs,scalp, lower back,face,palm,and
    sole of the feet,nails too…
    DEFINITION

    Psoriasis is a chronic,non infectious, inflammatory disease of the skin in which the


    production of epidermal cells occur at a rate that is about 6 to 9 times faster than normal.
    INCIDENCE

    1to 3% of world population


    Affects 7.5million of Americans
    . Onset may occur at any age
    . Median on set is at 28 age
    . More prevalent for women’s, caucasians and obese people
    ETIOLOGY

    Idiopathic
    Genetic disorder
    Autoimmune reaction
    Infection
    . Injury to skin.
    RISK FACTORS

    • Climatic change
    • Stress and anxiety
    • Trauma
    • . Smoking
    • Drugs such as propanalol, lithium..
    PATHOPHYSIOLOGY

    • T-cells are one of the immune cells


    • . 🔽
    In psoriasis,hordes of activated T cells
    . Are found in psoriatic skin and almost
    . None in healthy skin.
    🔽
    These activated T cells secrete interleukin-6
    CONTINUATION

    Which has as one of its effects the ability to stimulate


    Skin cell growth
    🔽
    A normal skin cell matures and she’d in 28 to 30 days
    . 🔽
    But a psoriatic skin cells takes only 3to4 days to mature
    . And move to the surface.
    CONTINUATION

    • 🔽
    • Instead of shedding the cells pileup and form
    • Lesions
    • . 🔽
    • Symptoms of psoriasis
    CLINICAL MANIFESTATIONS

    • The lesions appears as red, raised,patches of


    • Skin covered with silvery scales.
    • Dry patching, itching
    • Nail pitting, discoloration
    • Fever,chills
    • . Electrolyte imbalance
    • Frustration.
    DIAGNOSTIC EVALUATION

    • History collection
    • Physical examination
    • Skin biopsy
    • . Blood and radiography test was done
    • . To rule out psoriatic arthritis.
    MANAGEMENT
    PHARMACOLOGY THERAPY
    • Topical corticosteroids
    • . Topical calcineurine inhibitors
    • Vitamin D analogues
    • . Coal tar
    TOPICAL CORTICOSTEROID

    • These are commonly first line therapy in mild to moderate


    • Psoriasis and in sites such as the flexures and genetalia.
    . It shows improvement in 2 to 4 weeks
    . They slowly the cells turn over by suppressing the
    Immune system which reduce inflammation and relieves associated
    . Itching..and it’s used for smaller area like hands and feet.
    TOPICAL CALCINEURIN INHIBITOR

    • Topical calcineurin inhibitor is used to block the


    Synthesis of cytokines. Example..Tacrolimus and
    Pimecrolimbus.
    It is contraindicated in pregnant and nursing
    Mothers..
    VITAMIN D-ANALOGUES

    • It is effective,safe and well tolerated for the short


    • and long term treatment of psoriasis.
    • up to 100gm per week can be used.
    • Example..calcipotriene, calcitrol.
    COAL TAR

    • Coal tar is a thick dark liquid which is the by product


    • Of the production of coal.
    • It is a effective treatment for psoriasis.
    • 0.5 to 5% is considered safe and effective for
    • Psoriasis.
    SYSTEMIC THERAPY
    METHOTREXATE
    • Methotrexate 2.5mg tab and 50 mg / IM.
    • It blocks dihydrofolate reductase leading to
    • Inhibition of purine synthesis leading to accumulation
    • Of anti inflammatory adenosine.
    • Test dose starts with 2.5mg and then gradually
    • Increase the dose till 10- 15 mg weekly.
    CYCLOSPORINE

    • These agents act by inhibiting and eliminating


    • T-cells commpletely.
    • It is containdicated to pregnancy lactation,
    • Renal abnormalities.
    ULTRAVIOLET THERAPY

    • Ultraviolet therapy has been used to success fully


    • . Treat the psoriasis.
    • It is a wavelength of light in a range too short for human
    • Eye to see, when exposure to uvlight the activated
    • T cells in the skin are destroy which lead to reduces the
    • scaling and itching.
    • Side effects, nausea , vomitting, headache,skin cancer.
    NURSING MANAGEMENT

    • Advice the patient not to pick or scratch areas


    . Teach the patient to use bath oil or cleansing agent
    for sore and scaling.
    Take daily bath.
    Cover the affected area over night.
    Avoid drinking alcohol and smoking.
    Eat healthy diet.
    • Use mosturizer
    • Expose small amount of skin to sun light.
    • Apply medication cream and ointment.
    • Assist the patient to take rest.
    • Advice the patient to prevent the skin from
    • Drying out.

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