Integumentary Function: K.B.’s Psoriasis Case

1. Triggers and Clinical Types of Psoriasis:

Common triggers:

• Stress
• Skin injury (cuts, scrapes)
• Infections (streptococcal)
• Certain medications (beta-blockers, lithium)
• Alcohol and smoking
• Changes in weather

Clinical types:

• Plaque psoriasis (most common): Thick, red, scaly patches on skin.
• Guttate psoriasis: Small, teardrop-shaped lesions often triggered by infections.
• Inverse psoriasis: Smooth, red, inflamed areas in skin folds (groin, armpits).
• Pustular psoriasis: Small, white pustules on red, inflamed skin.
• Erythrodermic psoriasis: Severe inflammation affecting most of the body.

2. Treatment Approach for K.B.’s Relapse:

Considering K.B.’s history and current presentation:

• Topical corticosteroids: May not be sufficient due to generalized nature of outbreak.
• Systemic medications:
  • Methotrexate: Can be effective for widespread psoriasis.
  • Cyclosporine: Powerful option, but requires close monitoring.
  • Biologics (e.g., adalimumab): Target specific immune pathways, highly effective but expensive.
• Phototherapy: Ultraviolet light therapy can be helpful.
• Non-pharmacological options:
  • Moisturizers: Keep skin hydrated and reduce itching.
  • Sunlight exposure (controlled): Can improve symptoms in some cases.
  • Stress management: Reducing stress can help prevent flare-ups.

Medication review is important in K.B.’s case because:

• Some medications can worsen psoriasis (e.g., beta-blockers).
• Interactions between medications and psoriasis treatments can occur.
• Underlying health conditions (e.g., liver disease) can influence treatment options.

3. Other Manifestations of Psoriasis:

• Psoriatic arthritis: Joint pain, swelling, and stiffness.
• Nail changes: Thickening, pitting, and discoloration.
• Eye involvement (rare): Conjunctivitis, blepharitis.

Sensory Function: C.J.’s Eye Condition

1. Diagnosis:

Based on the presentation (crusting discharge, conjunctival erythema, otalgia, otitis media), the most likely diagnosis is acute bacterial conjunctivitis (ABC) with otitis media.

Rationale:

• Yellowish discharge, redness, and pain suggest inflammation and infection.
• Bilateral conjunctival involvement points towards infectious cause.
• Concurrent ear infection strengthens suspicion of bacterial etiology.

2. Determining Etiology:

Without further information (e.g., culture), pinpointing the exact bacterial cause (viral, bacterial, etc.) is impossible. However, the presence of otitis media suggests bacterial involvement is more likely.

3. Therapeutic Approach:

• Topical antibiotics: Eye drops or ointment to target bacterial conjunctivitis.
• Oral antibiotics: May be needed for otitis media if symptoms persist.
• Warm compresses: Can help relieve discomfort and promote drainage.
• Pain relievers: For symptom management.

Important note: This information is for educational purposes only and should not be used for diagnosis or treatment. Please consult a qualified healthcare professional for any medical concerns.