Psoriasis : What Is It ? Natural Treatment, Disease, and Nursing Management Definition
Psoriasis is a chronic noninfectious inflammatory disease of the skin in which the production of epidermal cells occurs at a rate that is approximately 6 -9 times faster than normal rate. Increased proliferation of epidermal cells induced by abnormal reaction of immune system.
In this condition the normal events to cell maturation and growth can not take place. This abnormal process does not allow formation of the normal protective layers of the skin.
The onset may occur at any age but is most common between the ages of 10 and 40 years, but may occur at any age. It has a tendency to improve and then recur periodically through out life.
Cell proliferation is mediated by the immune system.
Cause
The exact cause of psoriasis is not well determined. However, there appears to be a hereditary defect that causes over production of epidermal cell. A combination of specific genetic make-up and environmental stimuli may trigger the onset of the disease.
Aggravating factors/ triggering factor
♦ Emotional stress
♦ Anxiety
♦ Trauma
♦ Infections
♦ Seasonal and hormonal changes
♦ Cigarette smoking
♦ Alcohol consumption and drugs
♦ Non steroidal anti-inflammatory drugs.
Clinical manifestation:
-Lesions appear as dark red, raised plaque lesion covered with silvery scales
-Lesions produce multiple bleeding points when the scales are scraped away
-These patches are not moist and mostly is not itchy
-When psoriasis occurs on the palms and soles, it can cause pustular lesions
-Lesions can be symmetrical
Particular sites of the body tend to be affected
-Scalp
-The area over the elbows and knees, lower part of the back & genitalia
-The extensor surfaces of the arms and legs,
-Over the sacrum and the inter gluteal fold
If nails are involved, it may be presented by
- Pitting
- Discoloration
- Crumbling beneath the free edge and
- Separation of the nail plates
Complications
-Arthritis (the relation is not understood)
-Erytherodermic psoriasis (involving the whole body surface)
Treatment
Goal: To reduce the rapid turnover of the epidermis and to promote resolution of the psoriatic lesions
- Advise that the disease may persist for life with remission and exacerbation.
- Control the problem:
-Remove precipitating or aggravating factors
-Reduce stress
-Teach patient that treatment of severe psoriasis can be time consuming
Treatment topical systemic
1. Topical – slows down the over active epidermis: i.e act by suppressing the epidermal turnover epidermopoiesis
Eg. Tar preparations, salicylic acid, and corticosteroids.
2. Systemic therapy
• Systemic cytotoxic preparations such as methotrexate, have been used in treating extensive psoriasis that fails to respond to other forms of therapy in specialized center
Nursing management
-Teach patient to avoid picking or scratching the psoriatic area
-Teach patient to avoid any topical irritant or allergy- producing Substance
-Teach patient to report to physician for any infection that appears to aggravate the psoriasis
-Caution patient about medication because some drugs may worsen psoriasis.
-Patents need a balanced life, including recreation, exercise & rest
-Prevent drying of the skin
-Avoid frequent washing
-Water should not be too hot,
-Avoid vigorous rubbing by towel after bath
-Use skin emollients
- Help patient move toward self-acceptance
- Advice to be exposed to the sun
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