As a nurse, psoriasis should not be a new term. This multi-system disease would manifest as skin symptoms and is long-term. Many patients can experience their skin cells growing faster than normal. This abnormal development would cause a buildup of skin cells on the skin’s surface. The affected patient would have red and raised patches that are covered with scales on his/her skin. In general, the mild and moderate types of psoriasis will be managed in primary care. This makes it important for nurse practitioners to gain knowledge about this disease and the guidelines on topical treatments for it.

Probable Causes of Psoriasis:

It’s to be understood that the actual cause of psoriasis is still unknown. It has been found that the problems with the person’s immune system would cause his/her body to attack their own healthy skin cells. Most often, this disease is found to be occurring to a person if any of his/her family members have the condition already. It can be observed that flare-ups of this disease would come and go and are frequently caused by several triggers like:

Infections:

Microorganisms like bacteria, viruses, fungi, and so on would trigger the flare-up. In most cases, the flare-up in psoriasis is found to be following a sore throat.

Medicines:

Some medicines might also trigger a flare-up in patients. Common examples of such medicines are those that are used to treat high blood pressure and depression.

Damage in Skin:

The skin injuries like cuts, scrapes, or sunburns could also increase the risk of flare-ups in psoriasis.

Smoking and Consumption of Alcohol:

These habits are also known to increase the risk of encountering a psoriasis flare-up in the patients.

Stress:

Stress, may it be physical or emotional, could lead to a flare-up in psoriasis.

Types of Psoriasis:

Now, the probable causes of psoriasis are known. It’s time for the nurses to know about the types of psoriasis here:

Plaque psoriasis:

This is the most commonly occurring type of psoriasis. About eight out of ten people with psoriasis are found to be affected with this type. In this type, the patients will have raised red-colored and inflamed lesions that will be covered by silvery white scales.

Guttate psoriasis:

This is the type of psoriasis that tends to develop during childhood and young adulthood and would appear as small red-colored spots on the trunk and the limbs of the affected individuals. There are several triggers that could cause the sudden flare-ups in this type.

Inverse psoriasis:

These would appear as bright red-colored and shiny lesions in the following parts:

• Axilla
• Under the breasts
• Skin-folds
• Surrounding the genitals
• Buttocks

Due to the locations of the lesions, this type of psoriasis is found to be irritated by sweating and clothing in the affected individuals.

Pustular psoriasis:

This type will be marked by non-infectious, pus-filled white-colored blisters that are surrounded by red skin. There are three sub-types in pustular psoriasis:

• Palmoplantar pustulosis
• Acropustulosis
• Von Zumbusch psoriasis

Each of these will affect the specific regions of the body.

Erythrodermic psoriasis:

This is associated with the Von Zumbusch type of psoriasis and is found to be affecting much of the body. This type is marked by fiery red-colored skin with the widespread shedding of the scales.

Role of Nurses in Treating Psoriasis:

As nurses, it’s important to understand the significance of regular assessments, as well as the recognition of comorbidities at the early stage. When it comes to psoriasis treatment, the nurses will have to continuously assist the patients in the psychological aspects of the disease. Remember, the skin is a visible organ and hence, alterations to this would cause deeper psychological reactions for the patient. As this disease affects the appearance of the skin, the person’s sense of self-concept will be affected badly.

Therefore, nursing diagnoses would include the following types of responses from the patients:

• Body image
• Risk for social isolation
• Changes in self-esteem

Experts in the field state that nurses should be aware of recognizing the characteristics of these findings so that appropriate interventions could be developed. In general, the individuals with psoriasis will benefit from individualized skin care plans that could help with education on treatments and applications.

Take Home Pointers:

Although there are several effective approaches to the short-term management of psoriasis, the long-term use of some medications could be toxic, which could even lead to organ damage or cancers. This is very problematic, especially for the patients with moderate to severe psoriasis. A dermatology nurse will play a critical role in administering the medications appropriately and also in the patient education. In addition, they can play an important role in social, as well as psychological consequences in their patients.