Psoriasis Case Study No. 1

1. The most common causes of psoriasis and an explanation of the many clinical types:
Stress, skin damage, infections (such as streptococcal throat infection), certain drugs (such as beta-blockers and lithium), and environmental changes are common psoriasis triggers. Psoriasis is classified into several clinical forms, the most frequent of which are plaque psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis. Plaque psoriasis is distinguished by high, red spots covered with silvery scales. Guttate psoriasis manifests as tiny, dot-like lesions frequently caused by streptococcal infections. Inverse psoriasis presents as smooth, red lesions in skin creases. Pus-filled blisters on the skin distinguish pustular psoriasis, whereas erythrodermic psoriasis is characterized by widespread inflammation and skin exfoliation.

2. Different types of psoriasis treatments and the best method for K.B. :
Topical therapies (e.g., corticosteroids, vitamin D analogs), phototherapy (e.g., UVB, PUVA), systemic drugs (e.g., methotrexate, biologics), and oral retinoids are all choices for treating psoriasis. In the case of K.B.’s recurrence episode involving generalized plaque psoriasis, topical therapy and phototherapy would be the best approach. For the affected areas, high-potency corticosteroids, to which K.B. initially responded effectively, can be administered. Phototherapy, particularly UVB therapy, can target more expansive areas of involvement. Non-pharmacological alternatives and advice include frequent skin moisturization, avoiding triggers, controlling stress, and leading a healthy lifestyle.

3. The importance of medication review and reconciliation for K.B.: Medication review and reconciliation are critical since certain drugs might aggravate or provoke psoriasis. Any medicines that K.B. takes must be identified to examine their potential impact on her psoriasis. Beta-blockers and lithium, for example, are known to aggravate psoriasis symptoms. A medication evaluation allows healthcare providers to identify possible culprits and make necessary changes to K.B.’s treatment plan.

4. Other psoriasis manifestations: Psoriasis can appear in ways other than skin sores. Psoriasis patients may endure joint discomfort and swelling, known as psoriatic arthritis. Pitting, discoloration, and detachment from the nail bed are all possible nail alterations. Psoriasis can cause scaling and itching on the scalp. Individuals with psoriasis may also experience psychological and emotional effects such as low self-esteem, sadness, and anxiety.

Case Study 2: Eye Disease

1. C.J.’s eye problem is diagnosed:
C.J.’s diagnosis would be conjunctivitis with otitis media based on the clinical signs (yellowish discharge, bilateral conjunctival erythema, throbbing pain, and opaque, bulging, and red tympanic membrane). Conjunctivitis is an inflammation of the conjunctiva characterized by bilateral conjunctival erythema and discharge. Otitis medium, an infection of the middle ear, is characterized by throbbing pain and a red, bulging tympanic membrane. The two disorders are frequently linked in cases of viral or bacterial infections that can damage both the eyes and hearing.

2. Probable etiology of the eye affection: It is impossible to definitively define the etiology of C.J.’s eye ailment with the facts provided. However, taking into account

The most likely cause of the symptoms of yellowish discharge and conjunctival erythema, as well as the presence of otitis media, is a bacterial infection. Bacterial conjunctivitis is distinguished by purulent discharge and redness, and it may be associated with otitis media due to the disease spreading from the nasopharynx to the middle ear.

3. The best treatment approach for C.J.’s condition: Antibiotics would be the best therapeutic approach for C.J.’s disease because a bacterial infection is the most likely etiology. Topical antibiotic eye drops, or ointments such as fluoroquinolones or macrolides might be administered to treat bacterial conjunctivitis. Antibiotics administered systemically may also be indicated for the accompanying otitis media. An ophthalmologist or primary care physician should be consulted for a complete evaluation and suitable therapy.

1. Griffiths, C. E., Barker, J. N., and Bleiker, T. (2016). Rook’s Dermatology Textbook. John Wiley & Sons, Inc.
2. Mente, A., and K. Manmohan (2019). StatPearls [Internet]. Psoriasis. StatisticsPearls Publishing.
3. S. Michael, M. Moore, C. Maranzano, A. Hanlon, D. S. Dizon, and J. Ochoa (2020). A Review of Psoriasis. Dermatology and Therapy, vol. 10, no. 4, pp. 569-585.
(2019) American Academy of Ophthalmology. Preferred Practice Pattern® for Conjunctivitis. URL: https://www.aao.org/preferred-practice-pattern/conjunctivitis-ppp-updated-2019