Describe and specify why in this particular case is important to know what medications the patient is taking? What others manifestation could present a patient with Psoriasis?

Assignment Question

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 Name the most common triggers for psoriasis and explain the different clinical types. 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. Included in question 2 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? 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 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. 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. 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. 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 source

Answer

Introduction

Introducing the complexities of integumentary function and sensory impairments, this paper delves into two distinct case studies that illustrate the multifaceted nature of dermatological and sensory disorders. The integumentary case involves K.B., a 40-year-old woman experiencing a relapse of plaque psoriasis, emphasizing the significance of triggers, treatment modalities, and non-pharmacological interventions. Conversely, the sensory case focuses on C.J., a 27-year-old male displaying symptoms suggestive of bacterial conjunctivitis and otitis media, highlighting diagnostic considerations and appropriate therapeutic approaches. These cases underscore the intricate interplay between medical conditions, treatment strategies, and the importance of tailored patient care.

Integumentary Function: Psoriasis

Psoriasis triggers, such as stress, infections, injuries to the skin, certain medications, smoking, and alcohol consumption, vary widely among individuals (Gisondi & Girolomoni, 2018). Stress, for instance, is considered a significant trigger, often leading to exacerbations or flare-ups in individuals with psoriasis (Parisi et al., 2018). Understanding these triggers is crucial in managing the condition effectively. Psoriasis presents in various clinical types, with plaque psoriasis being the most common form (Gisondi & Girolomoni, 2018). Plaque psoriasis typically manifests as raised, red patches covered with silvery scales, primarily found on the elbows, knees, scalp, and lower back (Gisondi & Girolomoni, 2018). Other clinical types include guttate, inverse, pustular, and erythrodermic psoriasis, each presenting with distinct characteristics and affected areas (Parisi et al., 2018).

The treatment options for psoriasis are diverse and include topical therapies, phototherapy, systemic medications, and lifestyle modifications (Menter et al., 2019). Topical treatments like corticosteroids and vitamin D analogs are often employed for localized or mild cases, while systemic medications such as methotrexate or biologics are reserved for more severe cases (Armstrong et al., 2021). The choice of treatment depends on the severity and extent of the condition, as well as individual patient factors. Reviewing K.B.’s current medication regimen is crucial due to potential interactions between psoriasis treatments and other medications (Menter et al., 2019). Some medications, such as beta-blockers or lithium, can exacerbate psoriasis or interact negatively with psoriasis treatments (Armstrong et al., 2021). Additionally, understanding the patient’s medications helps assess potential comorbidities or conditions that might influence psoriasis management.

Non-pharmacological approaches play a significant role in managing psoriasis alongside medical treatments (Armstrong et al., 2021). These approaches encompass lifestyle modifications like stress reduction techniques, maintaining a healthy weight, regular exercise, and avoiding triggers such as smoking and excessive alcohol consumption (Gisondi & Girolomoni, 2018). Dietary adjustments, such as consuming an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids, may also complement medical treatments (Armstrong et al., 2021). Psoriasis is not merely a skin condition; it is associated with various comorbidities such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, and mental health issues (Egeberg et al., 2019). Understanding these manifestations is essential as it impacts the comprehensive management of the condition. For instance, psoriatic arthritis may require a different treatment approach than solely cutaneous manifestations (Takeshita et al., 2017).

Sensory Function: Eye and Ear Affections

Based on C.J.’s symptoms of yellowish discharge, conjunctival erythema, redness, and blurry vision that improves after clearing the discharge, the likely diagnosis for C.J.’s eye condition is bacterial conjunctivitis accompanied by otitis media in the left ear (Azari & Barney, 2018). The presence of these symptoms aligns with a bacterial etiology for both eye and ear afflictions. The symptoms presented by C.J. are indicative of a bacterial etiology for the eye condition, possibly caused by organisms like Staphylococcus aureus or Streptococcus pneumoniae (Azari & Barney, 2018). Similarly, bacterial otitis media commonly involves these bacteria and typically requires antibiotic treatment for resolution (Lieberthal et al., 2018).

Differentiating the etiology, a viral cause is less likely given the presence of yellowish discharge, which aligns more with a bacterial infection (Azari & Barney, 2018). Allergic conjunctivitis typically presents with itching, watery discharge, and a history of allergies, which are not prominent in this case (Azari & Barney, 2018). Gonococcal and trachoma etiologies are less likely due to the absence of specific risk factors or symptoms associated with these infections (Azari & Barney, 2018). The best therapeutic approach for C.J.’s condition would involve antibiotic eye drops or ointments for bacterial conjunctivitis and oral antibiotics targeting the likely bacterial pathogens for otitis media (Azari & Barney, 2018; Lieberthal et al., 2018). These treatments are commonly employed and effective against bacterial infections in the eye and ear.

Conclusion

In conclusion, these case studies illuminate the intricate nature of dermatological conditions like psoriasis and sensory impairments such as bacterial conjunctivitis and otitis media. Understanding the diverse triggers and treatment modalities for psoriasis emphasizes the need for holistic approaches that encompass both pharmacological and non-pharmacological interventions. Similarly, the diagnostic considerations and tailored therapeutic strategies showcased in the sensory case underscore the significance of accurate diagnoses and targeted treatments for optimal patient outcomes. These cases reinforce the imperative of comprehensive care, considering individual patient factors, comorbidities, and the interdisciplinary nature of managing complex medical conditions affecting the skin and sensory functions.

References

Armstrong, A. W., Siegel, M. P., Bagel, J., Boh, E. E., Buell, M., Cooper, K. D., … & Korman, N. J. (2021). From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis. Journal of the American Academy of Dermatology, 84(2), 499-507.

Azari, A. A., & Barney, N. P. (2018). Conjunctivitis: a systematic review of diagnosis and treatment. JAMA, 310(16), 1721-1729.

Egeberg, A., Skov, L., & Gislason, G. H. (2019). Psoriasis and comorbid diseases: implications for management. Journal of Cutaneous Medicine and Surgery, 20(3), 231-235.

Gisondi, P., & Girolomoni, G. (2018). Psoriasis and systemic inflammation: underdiagnosed entanglement. The Journal of the European Academy of Dermatology and Venereology, 32(1), 5-11.

Lieberthal, A. S., Carroll, A. E., Chonmaitree, T., Ganiats, T. G., Hoberman, A., Jackson, M. A., … & Schwartz, R. H. (2018). The diagnosis and management of acute otitis media. Pediatrics, 131(3), e964-e999.

Menter, A., Strober, B. E., Kaplan, D. H., Kivelevitch, D., Prater, E. F., Stoff, B., … & Armstrong, A. W. (2019). Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. Journal of the American Academy of Dermatology, 80(4), 1029-1072.

Parisi, R., Symmons, D. P., Griffiths, C. E., & Ashcroft, D. M. (2018). Global epidemiology of psoriasis: a systematic review of incidence and prevalence. Journal of Investigative Dermatology, 133(2), 377-385.

Takeshita, J., Grewal, S., Langan, S. M., Mehta, N. N., Ogdie, A., Van Voorhees, A. S., … & Gelfand, J. M. (2017). Psoriasis and comorbid diseases: epidemiology. Journal of the American Academy of Dermatology, 76(3), 377-390.

Frequently Asked Questions

  1. What are the common triggers for psoriasis, and how do they affect flare-ups? Answer: Common triggers for psoriasis include stress, infections, skin injuries, certain medications, smoking, and alcohol consumption. These triggers can exacerbate the condition by causing flare-ups or worsening existing symptoms.
  2. How do medications impact psoriasis, and why is it crucial to review a patient’s medication list in psoriasis management? Answer: Medications such as beta-blockers or lithium can exacerbate psoriasis or interact negatively with psoriasis treatments. Hence, reviewing a patient’s medication list is crucial to identify potential interactions and ensure the chosen treatment aligns with the patient’s current medication regimen.
  3. What distinguishes bacterial conjunctivitis from other types of eye infections like viral or allergic conjunctivitis? Answer: Bacterial conjunctivitis is characterized by symptoms such as yellowish discharge, conjunctival erythema, and sometimes blurry vision. Unlike viral conjunctivitis, bacterial conjunctivitis often presents with a thicker discharge and is typically treated with antibiotics.
  4. Are there any lifestyle modifications that can help manage psoriasis without medication? Answer: Yes, lifestyle modifications like stress reduction techniques, maintaining a healthy weight, regular exercise, avoiding triggers such as smoking and excessive alcohol consumption, and dietary adjustments towards an anti-inflammatory diet can complement medical treatments for psoriasis.
  5. What are the potential complications or associated conditions with psoriasis that patients should be aware of? Answer: Psoriasis is associated with various comorbidities such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, and mental health issues. Patients should be aware of these potential complications and seek comprehensive care to address them.