Triggers for psoriasis and different clinical types

Instructions:

All replies must be constructive and use literature. 

• Reply to Gricarly

Triggers for psoriasis and different clinical types

Psoriasis is a chronic, relapsing, proliferative, immune-mediated inflammatory disorder that involves the skin, scalp, and nails, often accompanied by systemic comorbidities such as cardiovascular disease, hypertension, inflammatory bowel disease, and other autoimmune disorders. Psoriasis can flare up due to various triggers. Some common triggers include environmental factors like stress, cold weather, excessive or insufficient sunlight exposure, dry skin or air, skin injuries such as cuts, burns, and insect bites, viral or bacterial infections, obesity, certain medications such as beta-blockers, antimalaria drugs, and lithium, and excessive alcohol consumption (Hill & Mitchell, 2023).

• The major different clinical types of psoriasis include Plaque Psoriasis, which is characterized by thick, red plaques covered by flaky, silver-white scales. When the scales are lifted, it causes bleeding, known as Auspitz sign. This type of psoriasis usually appears symmetrically on the scalp, extensor surface of the elbow, knees, and the gluteal cleft. In darker skin tones, the lesions may appear purplish or darker. Erythrodermic Psoriasis, on the other hand, is characterized by intense erythema and scaling that covers a large area of the body, usually from head to toe. The lesions are usually pruritic and painful, and there is a high risk for infections and fluid and electrolyte abnormalities due to the large skin surface area affected. Guttate Psoriasis is another type that is characterized by small, pink-red papules and plaques that usually appear abruptly and acutely with no necessary prior history of psoriasis. It may occur post-infection, such as streptococcal pharyngitis. The lesions are usually less than 1 cm in size and appear on the trunk and proximal extremities. They may remit, recur, or progress to plaque psoriasis. Inverse Psoriasis is characterized by erythema and irritation, usually with no scaling that occurs in the intertriginous areas such as armpits, groin, and skin folds. It is referred to as inverse as the location of the lesions is opposite of the usual extensor surface areas that are affected. Lastly, Pustular Psoriasis is characterized by papules or plaques with pustules surrounded by erythema. This type can be acute in onset, and severe forms can be associated with infectious signs such as malaise and fever. Systemic complications can include sepsis and respiratory, renal, or hepatic abnormalities. This type may present without a prior history of psoriasis, and may remit for years and also recur after a few years (Dlugasch & Story, 2021).

Psoriasis treatment and the best approach to treat this relapse episode for K.B. include 

non-pharmacological options

• Psoriasis is a chronic skin condition with no cure, but its symptoms can be significantly improved with treatment in most cases. The primary objective of psoriasis treatment is to halt the process that causes the buildup of skin cells and alleviate the symptoms. Typically, treatment involves a combination of three main approaches. Firstly, topical treatments which include corticosteroids, vitamin D analogs, retinoids, anthralin (Dritho-Scalp), calcineurin inhibitors, salicylic acid, coal tar, moisturizers, and dandruff shampoo. Secondly phototherapy such as sunlight, broadband ultraviolet B (UVB) phototherapy, narrowband UVB phototherapy,  photochemotherapy, or psoralen plus ultraviolet A and excimer laser. Thirdly systemic medications such as retinoids related to vitamin A,  methotrexate, cyclosporine, hydroxyurea,  phosphodiesterase 4 inhibitors, immunomodulators, or biologic drugs that block interactions between certain immune system cells such as tumor necrosis factor-alpha inhibitors (e.g., etanercept), anti-IL-17 (e.g., ixekizumab); anti-IL-12 and IL-23 (e.g., ustekinumab) and Janus kinase inhibitors (Tan & Alba, 2024).

Considering the broad and severe nature of K.B.’s relapse, a combination of topical treatments such as high-potency corticosteroids, vitamin D analogs, emollients, keratolytic agents such as salicylic acid, phototherapy such ultraviolet light therapy, and systemic medications, such as methotrexate or biologics drugs that target TNF-?, IL-17, and IL-23 may be necessary (McCance et al., 2019).

Furthermore, non-pharmacological approaches like stress management techniques, maintaining a healthy lifestyle, avoiding triggers, and regular skin moisturizing can also be helpful. It is important to acknowledge and address any psychosocial distress that may arise due to changes in physical appearance in patients with psoriasis. This may involve referrals to counseling or support groups, such as the National Psoriasis Foundation, to ensure adequate assistance and maintain a good quality of life (Dlugasch & Story, 2021).

Importance of medication and reconciliation review in this case of K.B

It is important to conduct a thorough review and reconciliation of the patient’s medications in this case, as certain medications, such as beta-blockers, antimalarial agents, or lithium, can worsen the symptoms of psoriasis or even trigger flare-ups. Having knowledge of the patient’s current medications is also essential in assessing potential drug interactions with any prescribed psoriasis treatments and creating a tailored treatment plan accordingly (Hill & Mitchell, 2023).

What other manifestations could present a patient with Psoriasis?

Other manifestations that a patient with psoriasis may present include joint pain, stiffness, and swelling, which is known as psoriatic arthritis. Nail changes such as pitting, onycholysis, subungual hyperkeratosis, and nail plate dystrophy can also occur and are known as psoriatic nail disease. Interestingly, nail changes can occur before any visible skin manifestations of psoriasis. In rare cases, only the nails are affected by psoriasis. Additionally, individuals with psoriasis may have psychological impacts such as depression, anxiety, decreased quality of life, and increased risk of developing other comorbidities, including uveitis, inflammatory bowel disease, metabolic syndrome,  hypertension, insulin resistance, dyslipidemia, abdominal obesity, chronic obstructive pulmonary disease, atherosclerosis, cardiovascular disease, and stroke that is independent of traditional risk factors for these diseases (McCance et al., 2019). 

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.