Psoriasis

.

1. PSORIASIS RATHEESH R L

2. Psoriasis is a chronic, non infectious, recurrent erythematous inflammatory disorder involving the keratin synthesis. Psoriasis is a persistent, long-lasting (chronic) disease.  Psoriasis causes cells to build up rapidly on the surface of the skin.

3. CAUSE The cause of psoriasis isn't fully known, but it's thought to be related to an immune system problem with cells in the body .

4. Risk factors Anyone can develop psoriasis, but these factors can increase your risk of developing the disease : Family history.   Perhaps the most significant risk factor for psoriasis is having a family history of the disease. Having one parent with psoriasis increases risk of getting the disease, and having two parents with psoriasis increases risk even more.

5. Viral and bacterial infections.   People with HIV are more likely to develop psoriasis than people with healthy immune systems. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.

6. Stress.   Because stress can impact the immune system, high stress levels may increase the risk of psoriasis. Obesity.   Excess weight increases the risk of psoriasis.

7. Smoking.   Smoking tobacco not only increases risk of psoriasis but also may increase the severity of the disease.

8. PATHOPHYSIOLOGY Normally keratinocytes migrate from the basal cells to stratum corneum within 14 days. In this disease the keratinocytes travel from the basal cells to stratum corneum within 4-7 days and immature growth of keratinocytes will occur and also leads production of lesions and erythema. Inflammation and plaque formation

9. CLINICAL FEATURES Red patches of skin covered with silvery scales Small scaling spots (commonly seen in children) Dry, cracked skin that may bleed Itching and burning Thickened nails Swollen and stiff joints Oozing of lesions

10. DIAGNOSIS History collection Physical examination Skin biopsy USG is performed to identify the changes in stratum corneum

11. MANAGEMENT Topical corticosteroids.   These powerful anti-inflammatory drugs are the most frequently prescribed medications for treating mild to moderate psoriasis . Eg: hydrocortisone and methyl prednisolone

12. Vitamin D analogues.   These synthetic forms of vitamin D slow down the growth of skin cells. Calcipotriene ( Dovonex ) is a prescription cream or solution containing a vitamin D analogue that may be used alone to treat mild to moderate psoriasis

13. UV therapy: It is used to decrease the growth rate of cells, its given three times in a day.

14. Photo chemotherapy In photo-chemotherapy a light activated medicine ( methoxsalen ) is used, it inhibits the DNA synthesis and decreases hyperkeratosis.

15. Lifestyle and home remedies Take daily baths.  Use moisturizer . Expose your skin to small amounts of sunlight . Avoid smoking Avoid drinking alcohol.

16. NURSING MANAGEMENT Complete assessment of the skin, Provide skin care Advice the patient to not scratch or pull the scales Provide warm water for bathing and instruct avoid hot water Instruct the patient to dry the skin by blotting with towel instead of rubbing with towel

17. Lubricate the skin with coconut oils it gives comfort from the sores. Apply prescribed medicines on correct time and the medicine should be keep away from the eyes and mucous membrane as it produce discofort .