Integumentary Function

Full Answer Section

Treatment Options:

Topical therapies:

• First-line: Corticosteroids (K.B.'s initial treatment), calcineurin inhibitors, vitamin D analogues, coal tar.
• Second-line: Combination therapies, retinoids.

Systemic therapies:

• Moderate/severe cases: Methotrexate, cyclosporine, acitretin, apremilast, biologics (e.g., adalimumab, ustekinumab).

Non-pharmacological options:

• Phototherapy: Ultraviolet light exposure can improve symptoms.
• Stress management: Techniques like yoga or meditation can be helpful.
• Skin care: Moisturizers and gentle cleansing routines are crucial.
• Support groups: Connecting with others with psoriasis can offer emotional support.

K.B.'s treatment approach:

Given K.B.'s previous response to topical corticosteroids and the limited nature of her initial flare-up, topical therapy remains a reasonable first-line approach. Options include:

• High-potency corticosteroids: Short-term use to control inflammation.
• Combination therapy: Combining corticosteroids with calcineurin inhibitors or vitamin D analogues.
• Coal tar: May be helpful for scalp involvement.

However, considering the widespread nature of this relapse, consultation with a dermatologist is crucial to assess if:

• Topical therapy alone is sufficient, or
• Systemic therapy or phototherapy is needed for better control.

Medication Review:

Medication review is crucial in K.B.'s case for several reasons:

• Drug interactions: Some medications can interact with psoriasis treatments, reducing their effectiveness or causing side effects.
• Triggering medications: Identifying and potentially adjusting medications that might be triggering K.B.'s flares.
• Comorbidities: Ensuring psoriasis treatments are compatible with any existing medical conditions K.B. may have.

Other Manifestations:

Psoriasis can also affect:

• Joints: Psoriatic arthritis causing pain, stiffness, and swelling.
• Nails: Pitting, thickening, and discoloration.
• Eyes: Conjunctivitis, blepharitis, and uveitis.
• Emotional well-being: Anxiety, depression, and social isolation due to the visible nature of the condition.

Remember: This information is for educational purposes only and should not be interpreted as medical advice. Please consult a qualified healthcare professional for diagnosis and treatment of psoriasis.

Sample Solution

Psoriasis Case Study: K.B.

Triggers and Clinical Types of Psoriasis:

Common triggers:

• Stress: Psychological or emotional stress can exacerbate psoriasis flares.
• Skin injuries: Cuts, scrapes, sunburns, and insect bites can trigger new lesions (Koebner phenomenon).
• Infections: Certain infections, like strep throat, can trigger flares.
• Medications: Some medications, like beta-blockers and lithium, can worsen psoriasis.
• Smoking and alcohol: These habits can increase the severity of psoriasis.
• Weather changes: Cold and dry weather can exacerbate symptoms.

Clinical types:

• Plaque psoriasis: Most common, with raised, red, scaly patches. K.B.'s case.
• Guttate psoriasis: Small, droplet-shaped lesions often triggered by infections.
• Inverse psoriasis: Smooth, red patches in skin folds (groin, armpits).
• Pustular psoriasis: Widespread, sterile pustules on red skin.
• Erythrodermic psoriasis: Rare, life-threatening form with widespread redness and scaling.