2. Psoriasis
• Psoriasis is a chronic, an inflammatory skin
disease in which skin cells replicate at an
extremely rapid rate. New skin cells are
produced about eight times faster than
normal, over several days instead of a
month
• This causes cells to build up on the skin's
surface, forming thick patches, or plaques,
of red sores (lesions) covered with flaky,
silvery white dead skin cells (scales)
• Onset may occur at any age but is most
common between the ages of 15 and 50
years
3. Causes of psoriasis
• The cause of psoriasis is not known,
but it is believed to have a genetic
component.
• Several factors are thought to
aggravate psoriasis. These include
stress, excessive alcohol consumption
and smoking.
• Individuals with psoriasis may suffer
from depression and loss of self-
esteem.
• As such, quality of life is an
important factor in evaluating the
severity of the disease.
4. Types of psoriasis
•Plaque psoriasis (psoriasis vulgaris)
is the most common form of
psoriasis. It affects 80 to 90% of
people with psoriasis. Plaque
psoriasis typically appears as raised
areas of inflamed skin covered with
silvery white scaly skin. These areas
are called plaques
5. Types of psoriasis
• Flexural psoriasis (inverse psoriasis)
appears as smooth inflamed patches of
skin. It occurs in skin folds,
particularly around the genitals
(between the thigh and groin), the
armpits, under an overweight stomach
(pannus), and under the breasts
(inframammary fold). It is aggravated
by friction and sweat, and is vulnerable
to fungal infections.
6. Types of psoriasis
• Guttate psoriasis is characterized by
numerous small oval (teardrop-
shaped) spots. These numerous spots
of psoriasis appear over large areas
of the body, such as the trunk, limbs,
and scalp. Guttate psoriasis is
associated with streptococcal throat
infection
7. Types of psoriasis
•Pustular psoriasis appears as
raised bumps that are filled with
non-infectious pus (pustules). The
skin under and surrounding
pustules is red and tender. Pustular
psoriasis can be localized,
commonly to the hands and feet
8. Types of psoriasis
• Nail psoriasis produces a variety of
changes in the appearance of finger
and toe nails. These changes include
discoloring under the nail plate, pitting
of the nails, lines going across the
nails, thickening of the skin under the
nail
9. Pathophysiology
• The basal skin cells divide too quickly, and the newly formed
cells become evident as profuse scales or plaques of epidermal
tissue. Psoriatic cells may travel from the basal cell layer of the
epidermis to the stratum conium (skin surface) and be cast off
in 3 to 4 days, in sharp contrast to the normal 26 to 28 days.
• Because of the rapid cell passage, the normal events of cell
maturation and growth cannot take place and the normal
protective layers of the skin cannot form.
• Psoriasis is considered mild if it affects less than 5% of the
surface of the body; moderate, if 5–30% of the skin is involved,
and severe, if the disease affects more than 30% of the body
surface
11. Diagnostic test
• Skin biopsy
• Skin swab flexural psoriasis
• Auspitz sign- gentle removal of
the silvery scale from a plaque
• Routine blood tests viral check
of full blood count
12. Treatment
This may involve tropical, systematic drug and phototherapy Drug therapy:
• Antihistamines such as cetrizen, Promethazine,
• Analgesics such as ibuprofen ,diclofenac, paracetamol
• Antibiotics such as cloxaciline, penicillin ,doxycycline, floxaciline, ampiciline
• Steroid-based creams. decrease inflammation, relieve itching, and block the production of
cells that are overproduced in psoriasis. E.g. hydrocortisone ,dexathamethasone
• salicylic acid ointment which smoothes the skin by promoting the shedding of psoriatic
scales e.g. silver nitrates
13. General nursing management
• Assessment focuses on how the patient is coping with the skin
condition, the appearance of “normal” skin, and the appearance of
skin lesions. Promoting Understanding
• Explain with sensitivity that there is no cure and that lifetime
management is necessary; the disease process can usually be
controlled
• Teaching Patient regarding the disease, skin care, and treatment
regimen.
• Measures to prevent skin injury: avoid picking or scratching
• Measures to prevent skin dryness: use emollients, avoid excessive
washing, use warm (not hot) water, and pat dry
• Use of the therapeutic relationship for support and to aid coping
• Development of self-acceptance
