The skin forms the largest part of the integumentary system. It also comprises hair and nails. The system protects the body against infections, excretes wastes products, and regulates temperatures. It also regulates the perspiration rates to protect the body from becoming dehydrated. Psoriasis is a genetically inherited skin disease, which is characterized by itchy, scaly and red patches. However, such environmental factors as oxidative stress and withdrawal from corticosteroids can trigger the symptoms. It occurs when a pathogen mistakably detects normal skin. In return, faulty signals result in catalyzing the overproduction of new skin. The new cells move rapidly to the surface of the skin, where they build up and form thick patches called plaques. In some cases, the skin flakes up.
The level of psoriatic effect can be mild, moderate and severe. These are dependent on several factors, which include the proportion of the affected surface area, the results of the disease and the characterization of the disease .
In mild cases, rashes appear only on small areas of the skin, while in moderate cases, the skin gets inflamed, loosen and scaly. It also becomes red and silvery. In severe conditions, patches are formed, which can join to cover large areas of the body, e.g. the entire back.
The table below shows the contrast and comparison among different types of psoriasis. These are illustrated in terms of symptoms, appearances and the most affected parts.
Type of Psoriasis
Red, white and silvery patches
Irritated and inflamed joints
Painful, swelly and stiff joints
Elbows, lower back and knees
Numerous and small lesions.
Pink or red lesions
Trunk limbs and scalp
Bumpy pus-filled patches;
Red and tender pustules
The whole skin
Fever, chills, nausea and muscle weaknesses
Nails become tender and painful, also change from yellow to brown;
Small pits on the nail surface
Toenails and fingernails
Common occurrences of fungal infections due to built of dead skin;
Smooth and inflamed patches;
Bright red and shiny non scaly patches
Genitals, armpits, beneath the breasts
Overgrowth of yeast infection due to its location
In mild cases, guttate psoriasis will disappear even without treatments. The pustular type is uncommon in children, but it is a serious condition that requires constant medical attention. It is mostly caused by systemic and topical medications, overexposure to UV rays, and stress.
Nurses should use medications and treatments that will help in clearing the lesions from the skin. The dosage and prescription will depend on the type of psoriasis, its severity, age and medical history. Psoriasis disorders are not curable because of their recurrent nature.
Medications for mild and moderate cases include moisturizers and lubricants, steroidal creams, antibiotics and antifungal means, coal tar preparations, Epsom salt solutions and vitamin D3. Creams and moisturizers are useful in reducing inflammation and clear the affected area. Retinoid containing coal tar and dithranol soothes the plaque skin. Use of mineral oil and moisturizer improves the condition of the dry skin. It also helps in soothing the affected area..
Phototherapy is allowed for systemic medications as either pills or injections. For effective administration, nurses should perform regular blood and liver tests. It is necessary to check the toxicity levels resulting from continued use of drugs. It is further recommended avoiding pregnancy with the majority of systemic treatments. Nurses should advise their patients to have an exposure to ultraviolet light because it helps to clear psoriasis in some people.
Patients with nail psoriasis should bathe in Epsom salt solutions. It helps to clear the debris of the dead cells that grow underneath the nails. Trimming the nails on a regular basis also reduces the severity. Nurses should advise and ensure that the psoriatic patients are changing their diets and lifestyles to reduce the psoriatic symptoms. Vegetarian diets and fish oil supplements are very beneficial. Gluten-free diet is given to patients, who are sensitive to drugs containing gluten.
Lifestyle habits like alcoholism, smoking, stress and obesity increases the severity of these disorders. On the other hand, improved sleeping patterns and exercises will reduce the degree of the prevailing condition. Due to its anti-inflammatory properties, use of cannabis may treat psoriasis symptoms. Additionally, it regulates the activities of the immune system, and therefore, reduces the chances of overproduction of skin cells. Due to the recurrent nature, lifelong therapies are highly encouraged .
For long-term treatment, it is recommended to use oral drugs, such as fumaric acid, which has unique immune modulator properties. In addition, fumaric acid has minimal suppression on the immune system. Nurses can also help patients to carry out home-based treatment procedures. This will involve the distribution of biologics for self-injections in order to control the adverse effects of these disorders .
Although psoriasis disorders are challenging to treat due to their recurrent nature, it is important to maintain healthy lifestyles. Habits such as smoking and alcohol intake will pose a threat in reducing the severity of psoriasis. It is advisable to protect the skin from excessive exposure to UV rays. Patients with long-term treatment should strictly follow the dosage to reduce the chance of reoccurrence.
Linda works as an editor and she is working on reaction paper apa format now. She has always enjoyed working with a variety of literature and being interested in new facts. In addition, she easily finds common ground with many people. She also received her master's degree from American University Washington