Posted: September 4th, 2023

K.B. is a 40-year-old white female with a 5-year history of psoriasis

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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 others manifestation could present a patient with Psoriasis?

Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.
Case Study Questions
1. Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.
2. With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
3. Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

Submission Instructions:
• You must complete both case studies.
• Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources

Integumentary Function

Case Study Questions

Name the most common triggers for psoriasis and explain the different clinical types.

The most common triggers for psoriasis include:

Infection: This is the most common trigger, and can be caused by a variety of infections, including strep throat, gut infections, and respiratory infections.
Stress: Stress can also trigger psoriasis, and it is thought to do so by activating the immune system.
Medications: Certain medications, such as lithium, antimalarial drugs, and beta-blockers, can trigger psoriasis.
Environmental factors: Exposure to cold weather, dry skin, and sunlight can also trigger psoriasis.

The different clinical types of psoriasis include:

Plaque psoriasis: This is the most common type of psoriasis, and is characterized by raised, red patches of skin that are covered with silvery-white scales.
Guttate psoriasis: This type of psoriasis is characterized by small, red dots that appear on the skin. It is often triggered by a strep throat infection.
Erythrodermic psoriasis: This is a severe form of psoriasis that can cover the entire body. It is characterized by red, inflamed skin that is often covered with scales.
Inverse psoriasis: This type of psoriasis occurs in the folds of the skin, such as the armpits and groin. It is characterized by red, smooth skin that may be moist or weepy.
Pustular psoriasis: This type of psoriasis is characterized by the formation of pustules, or small, pus-filled bumps. It can be a severe form of psoriasis.

There are several types of treatments for psoriasis, including:

Topical treatments: These treatments are applied directly to the skin, and include corticosteroids, vitamin D analogues, and retinoids.
Phototherapy: This treatment involves exposing the skin to ultraviolet light.
Systemic medications: These medications are taken by mouth or injection, and include methotrexate, cyclosporine, and acitretin.
Biologic medications: These medications are a newer type of treatment that targets the immune system.

The most appropriate approach to treat K.B.’s relapse episode will depend on the severity of her psoriasis. If her psoriasis is mild, she may be able to control it with topical treatments. If her psoriasis is more severe, she may need to take oral or injectable medications.

Non-pharmacological options: There are also a number of non-pharmacological options that can help to manage psoriasis, such as:

Keeping the skin moist: This can help to reduce scaling and itching.
Avoiding triggers: This includes avoiding infections, stress, and environmental factors that can trigger psoriasis.
Eating a healthy diet: Eating a healthy diet can help to improve overall health and well-being, which can also help to improve psoriasis.
Getting enough sleep: Getting enough sleep can help to reduce stress and improve overall health, which can also help to improve psoriasis.

Included in question 2.

A medication review and reconciliation are always important in all patient, but in this particular case is important to know what medications the patient is taking because some medications can trigger psoriasis or make it worse. For example, lithium, antimalarial drugs, and beta-blockers can trigger psoriasis.

Other manifestations that a patient with psoriasis could present include:

Joint pain: Psoriasis can sometimes affect the joints, causing pain and inflammation. This is known as psoriatic arthritis.
Eye problems: Psoriasis can sometimes affect the eyes, causing inflammation of the eyelids (blepharitis) or the conjunctiva (conjunctivitis).
Nail problems: Psoriasis can sometimes affect the nails, causing them to become thick, pitted, or discolored.
Mental health problems: Psoriasis can sometimes have a negative impact on mental health, causing symptoms such as depression, anxiety, and low self-esteem.

Sensory Function

Case Study Questions

1. Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.

The clinical manifestations presented in the case suggest that C.J. has conjunctivitis. Conjunctivitis is an inflammation of the conjunctiva, which is the thin, clear membrane that lines the eyelids and covers the white part of the eye. The most common cause of conjunctivitis is a viral infection, but it can also be caused by bacteria, allergies, or irritants.

The patient’s symptoms of crusty and yellowish discharge, blurry vision, and red eyes are all consistent The patient’s symptoms of crusty and yellowish discharge, blurry vision, and red eyes are all consistent with conjunctivitis. The crusty and yellowish discharge is a sign of inflammation, and the blurry vision is likely due to the inflammation of the conjunctiva. The red eyes are also a sign of inflammation.

In addition to the patient’s symptoms, the physical examination findings of bilateral conjunctival erythema and a yellowish discharge also support the diagnosis of conjunctivitis.

The most common cause of conjunctivitis is a viral infection, but it can also be caused by bacteria, allergies, or irritants. Viral conjunctivitis is usually mild and self-limited, lasting about 7-10 days. Bacterial conjunctivitis is more likely to cause a thick, purulent discharge and is more likely to require treatment with antibiotics. Allergic conjunctivitis is usually seasonal and is associated with other allergic symptoms, such as sneezing, coughing, and a runny nose. Irritant conjunctivitis is caused by exposure to irritants, such as smoke, dust, or chemicals.

Without further information, it is not possible to say for sure what the etiology of C.J.’s conjunctivitis is. However, the most likely possibility is that it is viral. This is because viral conjunctivitis is the most common type of conjunctivitis. Additionally, the patient’s symptoms are consistent with a viral infection.

If the patient’s conjunctivitis is viral, there is no specific treatment. However, there are some things that can be done to relieve the symptoms, such as:

Applying a cool compress to the eyes
Using artificial tears
Avoiding rubbing the eyes

If the patient’s conjunctivitis is bacterial, it will need to be treated with antibiotics. The doctor will likely prescribe eye drops or ointment containing antibiotics.

If the patient’s conjunctivitis is allergic, it will need to be treated with antihistamines or other allergy medications. The doctor may also recommend avoiding allergens that trigger the patient’s allergies.

2. With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

As I mentioned in the answer to question 1, without further information, it is not possible to say for sure what the etiology of C.J.’s conjunctivitis is. However, the most likely possibility is that it is viral. This is because viral conjunctivitis is the most common type of conjunctivitis. Additionally, the patient’s symptoms are consistent with a viral infection.

The other possible etiologies of conjunctivitis are bacterial, allergic, and gonococcal. However, these etiologies are less likely than a viral infection. Bacterial conjunctivitis is less common than viral conjunctivitis, and it usually causes a thicker, purulent discharge. Allergic conjunctivitis is usually seasonal and is associated with other allergic symptoms, such as sneezing, coughing, and a runny nose. Gonococcal conjunctivitis is a rare type of conjunctivitis that is caused by the bacterium Neisseria gonorrhoeae. It is usually seen in newborns who have been exposed to the bacterium during birth.

3. Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

If C.J.’s conjunctivitis is viral, there is no specific treatment. However, there are some things that can be done to relieve the symptoms, such as:

Applying a cool compress to the eyes
Using artificial tears
Avoiding rubbing the eyes

If C.J.’s conjunctivitis is bacterial, it will need to be treated with antibiotics. The doctor will likely prescribe eye drops or ointment containing antibiotics.

If C.J.’s conjunctivitis is allergic, it will need to be treated with antihistamines or other allergy medications. The doctor may also recommend avoiding allergens that trigger the patient’s allergies.

In the absence of further information, the best therapeutic approach to C.J.’s problem is to treat it as if it is viral conjunctivitis. This means that the doctor would likely prescribe artificial tears and recommend that C.J. avoid rubbing his eyes. If the symptoms do not improve within a few days, the doctor may then prescribe antibiotics or other medications.

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