Wound Wise: The skinny on psoriasis
Richard L. Pullen EdD, RN

Nursing Made Incredibly Easy!
October 2010 
Volume 8  Number 5
Pages 10 - 13
  PDF Version Available!

Psoriasis is a chronic, inflammatory autoimmune skin disease that affects as many as 7.5 million Americans, according to the National Institutes of Health. What's your role in caring for a patient with this condition? In this article, we'll take a look at nursing care and much more!Psoriasis develops when the immune system becomes overactive and produces too many white blood cells (called CD4 helper T cells), which causes an increase in blood flow to the skin, inflammation, and keratinocyte proliferation. Keratinocytes are epidermal cells that synthesize keratin and undergo chemical changes as they move upward from the basal layers of the epidermis. This means that new skin cells grow faster than the old skin can shed, known as cell turnover.In about one-third of cases, there's a family history of psoriasis. Skin trauma is a common precipitating factor in individuals who have a family history of the disorder. Stress, illness, dry climate, and some medications (such as lithium and beta-blockers) have been known to worsen the symptoms of psoriasis.Psoriasis lesions are generally red and circular, with a patchy appearance, and covered with heavy, dry, silvery scales. Often referred to as plaques, these patches are usually itchy and may be sore or painful. They most often occur on the elbows, knees, legs, scalp, lower back, face, palms, and soles of the feet; however, psoriasis lesions can occur anywhere on the body. Psoriasis lesions aren't contagious.Plaque psoriasis is the most common form of the disorder, characterized by skin lesions that are red at the base and covered by silvery scales (see Picturing plaque psoriasis). Other forms of psoriasis include: * guttate psoriasis—characterized by small, drop-shaped lesions that appear on the trunk, limbs, and scalp; most often triggered by upper respiratory infections * pustular psoriasis—characterized by blisters of noninfectious pus; attacks may be triggered by medications, infections, stress,

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