Instructions: Response must be at least 310 words written in current APA format with at least two academic references cited. References must be within the last five years. Response must extend, correct/refute, or add additional nuance.
Integumentary Function – Psoriasis
Psoriasis is a chronic skin disease that is characterized by deficiencies in the normal cycle of the epidermal development that lead to epidermal hyperproliferation, altered growth of the skin, inflammation, and vascular
dysfunction (Peters, Weissman, & Gill, 2000).
There are several types of psoriasis lesion that individuals can experience, and each may differ in the way they respond to treatment (Peters, Weissman, & Gill, 2000). The different types of psoriasis includes: plaque psoriasis
which is the most common type, and is characterized by dry scalling patches, guttate psoriasis is characterized by drop-like dots that develops in individuals recovering from a streptococcal or viral infection, erythrodermic psoriasis
characterized by exfoliation of fine scales that covers large areas accompanied by severe itiching, and pain (Peters, Weissman, & Gill, 2000). Other types of psoriasis are pustular psoriasis characterized as pus-like blisters that are not
infectious with fluids that contains white blood cells. Nail psoriasis that is seen on toe and finger nails; inverse psoriasis that is characterized by smooth, inflamed lesions mostly in flexural areas of the body, such as the armpits. Psoriatic
arthritis is characterized by an inflammation, swelling, and joint destruction, and scalp psoriasis that is a plaque type lesion (Peters, Weissman, & Gill, 2000).
The onset of psoriasis can be sudden or steady, and many patient such as K.B. will experience remissions, and exacerbations. The most common triggers for psoriasis are bacterial or viral infections on any part of the skin, dry air
or skin, use of certain medications such as beta blockers, and lithium. Other triggers are skin injuries, such as cuts, and insect bites, too little or too much sunlight, and excessive alchohol intake (Dlugasch & Story, 2021).
Although there is no cure for psoriasis, there are treatment available that will improve the symptoms. There three main approaches to treatment including topical treatments, phototherapy, and systemtic medications. Topical
treatments includes corticosteriods is the topical agent that is mostly used in treating psoriasis, and is used to reduce inflammation, itching, and scaling of lesions (Peters, Weissman, & Gill, 2000). Other topical treatments include
vitamin D, anthralin, retinoids, calcinerin inhibitors, salicylic acid, coal tar, mositurizers, and dandruff shampoo (Dlugasch & Story, 2021). Phototherapy is used in the treatment of moderate forms of psoriais, these therapies are
administered in the form of sunlight, natural or artificial, broadband ultraviolent B phototherapy, photochemotherapy, and excimer laser (Dlugasch & Story, 2021). Oral or injectible forms of treatment are usually prescribed for
individuals with serve symptoms or those who are resisitant to other forms of treatment (Dlugasch & Story, 2021). These systemic theraputic agents are retinoids, methotrexate, cyclosporine, hydroxyurea, phosphodiesterease 4 inhibitor,
immunomodular drugs, and janus kinase inhibitors. These medications are used for a short time due the potential for individuals to experience serious side effects (Dlugasch & Story, 2021). In addition to the treatment modalitied
mentioned, stress management, and referral to a therapist to address the patients’ psychological needs is important. Recommendation for treatment in this case would include phototherapy, systemic therapy, and psychotherapy to address
K.B. emotional needs.
The medications used to treat psoriasis has severe adverse effects such as phototoxicity, nephrotoxicity bone marrow depression, and others, as a result. In addition, there is a high probability of these drugs to interact with other
medications that could result in a negative outcome; therefore it important to reconcile the medications that patient is taking (Peters, Weissman, & Gill, 2000).
Other clinical manifestations as mentioned above may include psoriatic arthritis that is characterized by joint pain, nail changes to include yellow-brown spots, dents on the nails, and separation from the base. An individual may
also experience symptoms of cardiovascular disease, inflammatory bowel disease, hypertension, and other autoimmune disorders as there is an increased risk associated with psoriasis that may be manifested as skin lesions (Dlugasch &