Case Study 1: Integumentary Function Of A 40-Year-Old White

Case Study 1 Integumentary Functionkb Is A 40 Year Old White Fem

Case study # 1: Integumentary Function: K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids.

She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs. Case Study Questions 1. Name the most common triggers for psoriasis and explain the different clinical types. 2. There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations. 3. Included in question 2 4. A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking? 5. What other manifestations could present in a patient with psoriasis?

Paper For Above instruction

Psoriasis is a chronic autoimmune skin condition characterized by the rapid proliferation of keratinocytes leading to thickened, scaly plaques on the skin’s surface. It manifests in different clinical types, with plaque psoriasis being the most prevalent, characterized by raised, well-demarcated erythematous plaques covered with silvery scales. Other clinical types include guttate, pustular, inverse, and erythrodermic psoriasis, each with distinct features and triggers.

The most common triggers for psoriasis encompass environmental and internal factors such as stress, infections (particularly streptococcal), skin trauma (Koebner phenomenon), medications (beta-blockers, lithium, antimalarials), obesity, smoking, and excessive alcohol consumption. Hormonal changes and climatic factors, like cold and dry weather, can also precipitate flare-ups. The understanding of triggers is essential for managing exacerbations and tailoring treatment plans.

For K.B.'s relapse, given her generalized and extensive lesions, a systemic approach might be appropriate. Initiating biologic therapy could provide significant relief and remission, especially if she has failed or tolerated prior systemic treatments. Non-pharmacological options include lifestyle modifications such as weight management, smoking cessation, stress reduction techniques, and skin care routines emphasizing regular moisturizing and gentle skin care to prevent trauma. Patient education about avoiding known triggers and adherence to prescribed treatments are vital components of comprehensive care.

Medication review and reconciliation are crucial in psoriasis management because many drugs can influence disease activity or interact with therapy. For example, beta-blockers and lithium are known to exacerbate psoriasis. Knowing her current medications helps prevent adverse interactions, adjust treatments accordingly, and identify additional modifiable risk factors. Accurate medication history allows for safe prescribing and helps tailor specific interventions to optimize outcomes.

Systemic psoriasis can also involve other manifestations such as psoriatic arthritis, which affects approximately 30% of patients, leading to joint pain, stiffness, and swelling. Other complications include nail psoriasis, which can cause pitting, onycholysis, and subungual hyperkeratosis, significantly affecting quality of life. Psoriasis is also associated with metabolic syndrome, cardiovascular diseases, and psychological conditions such as depression, emphasizing the importance of a holistic approach to management.

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