How to write an Integumentary and Sensory Function Case Studies (Solved)

Psoriasis triggers and the clinical types

Psoriasis is a long-term periodic, immune-mediated illness affecting the skin and joints and has no cure (Nair & Badri, 2022). This disorder has a significant native impact on the victims’ social, emotional, physical, and psychological well-being. While it is firmly attributed to genetics, several modifiable factors trigger psoriasis flare-ups. The most common triggers include infections like streptococcus respiratory or skin infections, skin injury with a sharp object or through sunburn, excessive intake of alcohol, extreme weather conditions, medications such as lithium, antihypertensive, and antimalarial, and sudden withdrawal of systemic corticosteroids (Nair & Badri, 2022).

Table of Contents

The different clinical types of psoriasis have varying signs and symptoms. The first is plaque psoriasis which is the most common. It is characterized by dry, itchy, scaly plaques commonly found on the elbows, knees, scalp, and lower back. Brown and dark skin usually experience post-inflammatory hyperpigmentation on the affected skin areas (Nair & Badri, 2022). The second is guttate psoriasis which mainly affects young adults and children. According to Nair and Badri (2022), the most common trier is a streptococcus throat infection. The psoriasis spots appear small and drop-shaped with scales and are commonly located in the arms, legs, or trunk.

Psoriasis treatment

The pharmacological treatment methods for mild to moderate psoriasis include using topical agents such as coal tar, corticosteroids, retinoid, vitamin D analogs, and dithranol (Griffiths et al., 2021). These are combined with emollients and moisturizers to improve skin barrier function and preserve hydration (Nair & Badri, 2022). A lack of positive response to the topical agents invites using methotrexate. When patients do not respond to methotrexate, biological agents are introduced and sometimes used in conjunction with methotrexate (Griffiths et al., 2021).

The non-pharmacological therapies involve phototherapy using solar and ultraviolet radiation, biofeedback, and stress reduction (Griffiths et al., 2021). The most appropriate treatment for K.B. would be methotrexate and stress reduction.

Clinical features

Other psoriasis clinical manifestations include lesion development at the trauma site (Koebnner’s phenomenon, generalized exfoliative erythroderma in progressive psoriasis, and nail involvement in psoriatic arthritis (Griffiths et al., 2021).

Sensory function

Diagnosis

The most appropriate diagnosis for C.J. would be hyper acute bacterial conjunctivitis with otitis media infection. The patient has yellowish discharge from the eyes, and bilateral conjunctival erythema, suggesting a bacterial origin of conjunctivitis. Also, his ear canal examination reveals a bulging and red tympanic membrane and pain, which strongly suggests otitis media.

Etiology

The eye infection presented is bacterial. This is because the discharge is yellowish, and there are accompanying symptoms of bacterial ear infection. The color of the discharge varies with different etiologies. Pippin and Le (2021) support these findings through their review that patients with bacterial conjunctivitis manifest with eye redness, tearing, and purulent or mucopurulent discharge.

Therapeutic approach

Bacterial conjunctivitis is an infectious illness. Thus, the most appropriate treatment for C.J. would be an ophthalmic antibiotic such as 0.6% besifloxacin 1drop TDS in the affected eye(s) for seven days. The patient would also need a systemic antibiotic such as amoxicillin-clavulanate 1g B.D. for five days to clear the ear infection (Azari & Arabi, 2020).

References

Azari, A. A., & Arabi, A. (2020). Conjunctivitis: A Systematic Review. Journal of ophthalmic & vision research, 15(3), 372–395. https://doi.org/10.18502/jovr.v15i3.7456

Griffiths, C. E., Armstrong, A. W., Gudjonsson, J. E., & Barker, J. N. (2021). Psoriasis. The Lancet, 397(10281), 1301-1315.

Nair PA, Badri T. (2022). Psoriasis. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448194/

Pippin, M. M., & Le, J. K. (2021). Bacterial Conjunctivitis. In StatPearls [Internet]. StatPearls Publishing.