Psoriasis presents with well-defined, raised, erythematous plaques covered with silvery scales that are usually symmetrical. The most common type is chronic plaque psoriasis, characterized by pink plaques on the elbows, knees, scalp and back. Guttate psoriasis causes many small lesions, often after a streptococcal infection, while flexural psoriasis affects skin folds. Treatment includes topical emollients, keratolytics like coal tar to remove scales, and corticosteroids to reduce inflammation. Nursing diagnoses include impaired skin integrity from lesions and itching, risk of infection from loss of fluid and protein, and acute pain from inflammation.

2. Psoriasis

3. CLINICAL PRESENTATION OF PSORIASIS
Well defied and sharply demarcated.
Round / oval shaped lesions.
Usually symmetrical.
Erythematous raised plaques.
Covered by white silvery scales.

4. TYPES OF PSORIASIS
CHRONIC PLAQUE PSORIASIS
Most common type.
Pink, well defined plaques with silvery.
Lesions may be single or areas of skin.
Affects elbow, knees, buttocks and scalp.

5. GUTTATE PSORIASIS
Numerous and small lesions.
pink with less scale than plaque psoriasis.
Commonly found on trunk and proximal limbs.
Typically seen in individual < 30 years.
Often preceded by an upper respiratory streptococcal infections.

6. FLEXURAL PSORIASIS
Lesions in skin folds particularly groin, gluteal cleft, axillae and sub mammary
regions.
Often minimal or absent.

7. ERYTHRODERMIC PSORIAIS
Generalized erythema covering entire skin surface.
Patient may become febrile,
hyperthermic and dehydrated.
Relatively uncommon.

8. PALMOPLANTAR PSORIASIS
Can be hyperkeratotic or pustular.
May mimic dermatitis look for psoriasis manifestations.
Possibly aggravated by trauma.

9. SCALP PSORIASIS
Varies from minor scaling with erythema to thick hyperkeratotic plaques.
May extend beyond hairlines.
Patient scratching may produce asymmetric.

10. NAIL PSORIASIS
May be present in patient with any type of psoriasis.
Nail separates from nail bed at free edge.
Silvery white crusting under free edges of nails with
some thickening of nail plate.

11. TOPICAL THERAPIES
EMOLLIENTS
Include aqueous cream, sorbolene cream, white soft paraffin and wool fats.
Regular use can,
Alleviate pruritis.
Reduce scale.
Enhance penetration of ,
concomitant topical therapy.
Soap should be avoided.

12. KERATOLYTICS
Helps dissolve keratin to soften and lift psoriasis scales.
COAL TAR
Helps reduce inflammations and pruritis.
DITHRANOL
Anti-proliferative properties.
Not suitable of chronic plaque psoriasis.

13. CORTICOSTERODIS
Possess anti-inflammatory, antiproliferative and immuno-modulatory properties.
Reduce superficial inflammation within plaques.
Potency choice depends on disease severity, location and patient preference.

14. NURSING DIAGNOSIS
Impaired skin integrity related to lesions and inflammatory response as evidence
by itching all over the body.
Risk of infection related to hyponatremia as evidence by loss of protein and
fluid from lesions.
Acute pain related to inflammation as evidence by patient verbalization and pain
scale reading.