PSORIASIS, MALIGNANT MELANOMA, ALOPECIA.pdf

Psoriasis definition, types, causes,
signs and symptoms, complication, diagnosis, treatment, nursing management, Malignant melanoma definition, causes,
signs and symptoms, medical management, nursing management, Alopecia definition, types, causes, clinical manifestation, diagnosis, medical management, nursing management,

1. . PREPARED BY DOLISHA WARBI

2. PSORIASIS:
ØThis is one of the commonest and most intractable disorder of the skin.
ØIt is an autoimmune disease that appears on the skin.
DEFINITION:
•It is a chronic inflammatory disease of the skin characterized by clearly define dry, rounded red patches with
silvery scales on the surface.

3. TYPES OF PSORIASIS BASED ON AETIOLOGY:
Guttate psoriasis
•It is caused by streptococcal infection (pharyngitis or perianal). It appears as small, scaly red, tear-drop shaped called
papules. It is mainly seen in children and young adults.
Pustular psoriasis
•Its symptoms include pustules which are yellow, pus-filled lesions. They can be Generalized pustular psoriasis (GPP)
which covers many parts of the body, or Localized pustular psoriasis covering smaller areas on the palms of the hands
or the soles of the feet.
Plaque psoriasis
•It is the common form of psoriasis and appears as raised, inflamed, red scaly patches with a silvery-white coating at
the top. It can be tender, itchy and painful. They appear on the back, elbows, knees, and scalp.
Erythrodermic Psoriasis
•Erythrodermic psoriasis is uncommon. It causes severe redness and shedding of skin layers in large sheets.
Erythrodermic psoriasis appears over the entire body and can be life-threatening. Its symptoms include severe itching
and pain, changes in heartbeat, fever, dehydration and changes in the nail texture.

4. .

5. SIGNS AND SYMPTOMS:
•Red scaly, white patches
•Small scaling spots mostly in children
•Dry, cracked skin
•Burning, itching or soreness
•Pitted or cracked nails
•Joint pain
•Stiff joints
•Itching sensation
COMPLICATIONS -
•Psoriatic arthritis
•Eye problems like conjunctivitis, uveitis and blepharitis
•Obesity
•High blood pressure
•Type 2 diabetes
•Cardiovascular disease
•Certain autoimmune illnesses, such as sclerosis, celiac disease, and the inflammatory bowel disease called Crohn's disease
•Mental health problems, such as depression and low self-esteem

6. DIAGNOSIS:
Medical history and Examination,
Biopsy.
TREATMENT:
qCorticosteroids
qVitamin D
qRetinoids
qSalicylic acid
qLight therapy
qSunlight
qCoal tar preparations(keratoplastics ): These can help reduce inflammation, itching, and scaling

7. NURSING MANAGEMENT:
•Patient Education–>to avoid flare ups. Avoid stressors. Moisturize.
•Tissue/Skin Integrity. Skin has lesions from buildup of cells.
•Immunity–>autoimmune disease.
•Infection Control–>may be initiated by or lead to infection.

8. MALIGNANT MELANOMA:
A tumor arising from melanocytes of the basal layer of the epidermis.
Or
Malignant melanoma (see the image below) is a neoplasm of melanocytes or a neoplasm of the cells that develop
from melanocytes.

9. CAUSES:
•Ultraviolet (UV) radiation exposure from sunlight or tanning beds is a significant risk factor.
•Fair skin, history of sunburns, family history of melanoma, and presence of many moles or atypical moles are also
risk factors.
•Genetic factors and immune suppression can contribute.
SIGNS AND SYMPTOMS:
•Asymmetrical, irregularly bordered, multi-colored (variations of brown, black, blue, red, or white) lesion.
•Changes in size, shape, or color of an existing mole.
•Itching, bleeding, or ulceration of a mole.
•Enlarged lymph nodes if the cancer has spread.

10. MEDICAL TREATMENT:
•Immunotherapy: Drugs like pembrolizumab or ipilimumab can boost the immune system to fight cancer cells.
•Targeted Therapy: Drugs like vemurafenib or dabrafenib target specific mutations in melanoma cells.
•Chemotherapy:
SURGICAL TREATMENT:
•Wide Local Excision: Surgical removal of the tumor with a margin of normal tissue to ensure complete removal.
•Lymph Node Dissection: Removal of affected lymph nodes if cancer has spread.
NURSING MANAGEMENT:
•Education: Provide information on skin self-examination, sun protection, and the importance of regular follow-ups.
•Wound Care: Assist with post-operative wound care and monitor for signs of infection.
•Emotional Support: Offer emotional support to patients and families, as a diagnosis of melanoma can be distressing.
•Symptom Management: Assist with managing symptoms related to treatment, such as fatigue, nausea, and pain.
•Monitoring: Monitor for signs of recurrence or complications, and facilitate timely follow-up appointments.

11. ALOPECIA :
 Alopecia is defined as the loss of hair from areas where hair normally grows.
Alopecia is defined as “ absence or loss of hair”.
According to Brunner – “Partial or complete baldness or loss of hair”.
•It’s a chronic disorder secondary to the disease of either the hair follicle, hair shaft or the scalp.
TYPES:
•The main types of hair loss are:
•Alopecia Areata (AA).
•Alopecia Totalis (AT).
•Alopecia Universalis (AU).
•Alopecia Barbae.
•Androgenetic Alopecia (AGA).
•Scarring Alopecia (Cicatricial Alopecia).

12. .
Alopecia Areata (AA):
Alopecia areata is an autoimmune condition which
causes patchy hair loss. It can result in a single bald
patch or extensive patchy hair loss.
Alopecia Totalis (AT).
Alopecia totalis is a more advanced form of alopecia
areata which results in total loss of all hair on the
scalp.
Alopecia Universalis (AU) .
Alopecia universalis is the most advanced form of
alopecia areata which results in total loss of all hair
on the body, including eyelashes and eyebrows.

13. .
Alopecia Barbae
Alopecia barbae is alopecia areata that is localized to
the beard area. It can be a single bald patch or more
extensive hair loss across the whole of the beard area.
Androgenetic Alopecia (AGA)
ØAlso known as male pattern baldness or female
pattern baldness.
ØIt is a thinning of the hair to an almost transparent
state, in both men or women.
ØIt is hereditary.
ØIn both men and women, it's linked to having an
excess of male hormones (androgens) around the
hair follicles, which can block hair growth.
ØWomen are more likely to develop androgenic
alopecia after menopause, when they have fewer
female hormones.

14. CAUSES:
üExposure to allergens, irritants, toxins, burns, injuries, and infections.
üCertain medications (especially anabolic steroids like testosterone)
üChronic kidney failure
üRadiation and chemotherapy
üMalnutrition

15. CLINICAL MANIFESTATION:
ØHair loss. Hair usually falls out in small patches on the scalp.
ØHair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of
the body.
ØGradual thinning on top of head.
ØCircular or patchy bald spots.
ØSudden loosening of hair.
ØFull-body hair loss.
ØPatches of scaling that spread over the scalp.
ØChange in hair texture.

16. DIAGNOSIS:
1.Physical Examination
2.Medical History
3.Blood Tests.
4.Scalp Biopsy
Collect History of – (Time period of hair loss(congenital, acquired). Progression of hair loss. Any positive family history.
H/o G.I dysfunction, thyroid gland dysfunction. Psychological disorders. H/o any surgical intervention / chronic illness.
All medications. In females, menstrual & obstetric history. Hair care routine/ hair products).

17. MEDICAL MANAGEMENT:
1.Topical Treatments: Minoxidil (Rogaine).
2.Oral Medications: Finasteride (Propecia) for androgenetic alopecia in men and sometimes in women under specific
circumstances.
3.Steroid Injections: Injected directly into the scalp to reduce inflammation and stimulate hair growth in certain types
of alopecia.
4.Immunotherapy: For alopecia areata, medications like corticosteroids or immunosuppressants may be used to
suppress the immune response.
5.Hair Transplant Surgery
6.Wigs or Hairpieces
NURSING MANAGEMENT:
1.Education
2.Scalp Care
3.Emotional Support
4.Medication Administration
5.Monitor Side Effects
6.Follow-up

18. THANKS YOU