Brian is a 27-year-old male who suffers from plaque psoriasis (L40.0). His symptoms include red, itchy, flaking plaques located on his scalp, genitalia and legs with a BSA of 11%. Brain has tried and failed various treatments including triamcinolone and fluocinolone, both provided him with little to no relief. Brian is not a candidate for said biologics, because they can raise the risk of possibly fatal infections, Lymphoma, and other malignancies. I believe those risks of infection, malignancies are too high for Brian, in addition to both Humira, and Enbrel suppresses the immune system. Systemic medications are also too much of a risk for Brian because they have adverse side effects, which can also be extremely fatal and he is still of
The Integumentary is a vast organ system composed of exocrine glands, hair, nails, and the most commonly known organ, the skin. As a large system, it can be susceptible to many different types of diseases, one of these diseases are called Psoriasis. This affects a large portion of the Integumentary system, the skin. Psoriasis are considered to be a widespread, common and recurring disease that can be chronic at times. Psoriasis are defined by its appearance of light silver in color, flaky, rash on many parts of the Epidermis.
Background: Plaque psoriasis is a painful autoimmune disease that affects up to 3% of the US population.1 Moderate-to-severe psoriasis can have significant psychological and physiological effects on a person’s health and although psoriasis can be controlled, it cannot be cured, so medications play an important role in reducing related comorbidities and improving patients’ quality of life.2
Psoriatic arthritis is a form of arthritis that affects certain people. It is normally characterized by red patches on skin and scale like features. This disease develops differently, with some people contracting the psoriatic arthritis first before the joint pains and vice versa. As per now, there is no known cure for this disease. Obesity is acondition were the health of an individual is put at risk because of body fat that accumulates in the body. Over the years doctors have discovered growing cases of people with both diseases. The major difference was that psoriatic arthritis was worse in people that are overweight or obese they have a harder time because of how much they weigh. Recent research also proves that unlike their counterparts that weigh normally, obese people are less likely to reach minimal disease activity in a year. This can be explained in a variety of ways.
Jessica is a 25-year-old female who suffers from plaque psoriasis (L40.0). Her symptoms include red, itchy, thick plaques located on her arms and legs, with a 20% BSA. Jessica has tried and failed various treatments including Narrow band UVB, humira, betamethasone, derma-smooth, fluocinonide, clobetasol, hydrocortisone, and otezla, all provided her with little to no relief. Your denial states Jessica must try and fail methotrexate, however, systemic medications such as Methotrexate can cause serious problems with pregnancy and are not advised for patients; male or female, who could parent a child. Furthermore, she is not a candidate for treatment with Methotrexate due to the adverse side effects (which can be fatal) of these treatments. As
Psoriasis is a inflammatory and hyper proliferative disease of the skin, which is caused by the immune system. The immune system is overactive causing for cells to be produced at a faster rate than normal. Someone with Psoriasis immune system will attack their skin cells causing for damage in the skin. The Immune system produces T-cells which aid in recognizing foreign invaders and attacking them. However, with psoriasis the T-cells mistakenly identify skin cells as invaders and attack them. Furthermore, the attack on the skin cells leads to skin damage causing for the body to produce skin cells at a higher rate. The integumentary which is responsible for the production of skin cells is affected and goes in hyper drive. Normally, it would take approximately, a month to produce new skin cells, however, when someone has Psoriasis skin cell production is at a higher rate. Psoriasis causes for new skin cells to be produced at faster rate causing for skin cells to surface in 3-4 days. The body cannot shed skin cells at that rate which causes for old skin cells to pile up and cause flakey watched know as plaques. Scientist have discovered five different forms of psoriasis.
Psoriasis is a chronic skin disorder, easily identified by its symptoms of white, scaly skin and red lesions, though not so easily cured or understood. In psoriasis, skin cells mature faster than the body can shed them, causing a buildup. Although there are many theories as to what the cause of such a disease might be genetics, stress, or other triggers no one is quite sure why the disease occurs, or what could be a possible way to fully cure it. In this essay we will explore the symptoms, types, and effects of this condition, and also some of the known treatments.
Psoriasis is an extremely well-known disease of the Integumentary system that create a red, dry rash on the elbows, back, stomach, knees, palms, etc. The rash Psoriasis causes covers the infected area with dead skin cells that appear like silver scales. The disease cannot be cured, only treated, meaning that the symptoms can be agonizing to many patients with chronic forms. The scientific journal excerpt “Psoriasis Uncovered,” goes into depth about the causes, symptoms, age onset, and many more details about the disease.
Psoriasis is a life long chronic skin condition that starts under the skin and can range from a very mild case to a very severe case. Psoriasis is one of the most perplexing and relentless skin conditions. There are many symptoms of psoriasis. Itchy, scaly skin on the scalp, knees, elbows and upper body are some of the symptoms or psoriasis. Psoriasis on the fingernails and toenails can make the nails become thick, pitted, and discolored. The nails could possibly separate from the underlying nail bed. Psoriasis is caused when the gene that contains your immune system gets mixed up. The gene is supposed to protect the body from invaders; however, it causes inflammation in the skin and causes the skin cells to go into overdrive. The gene determining
If you are diagnosed with plaque psoriasis, there are different types of treatments available to you such as those shown in Figure 2. Your doctor may suggest a combination and/or a stand-alone treatment. There is not a single treatment that works for everyone who is diagnosed with plaque psoriasis. Medical care may involve topical, phototherapy, and systemic
Sharon is a 76-year-old female who suffers from plague psoriasis (L40.0). Sharon’s symptoms include burning, itching, scaly, extensive plaques located on her hands, feet, and scalp. Previously, Sharon has tried and failed various treatments including taclonex, prednisone, temavate, clobetasol, fluocinonide, lidex, and UV, with little to no relief. The denial states that Sharon needs to try Humira and Enbrel both suppress the immune system. Both of these medications carry warnings for an increased risk of serious infections and malignancies. Otezla, like its biologic counterparts, also minimizes inflammation at the intracellular level, but is not an immunosuppressant. In addition, Otezla is an oral medication eliminating painful injections,
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease associated with psoriasis. PsA consist of peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail disease. Most patients with peripheral arthritis present with polyarticular disease, with 5 or more joints involved. The distribution tends to be asymmetrical. Isolated distal joint involvement may occur in 5% to 10% of the patients. Oligoarticular disease occurs in 37% of the patients. Oligoarticular presentations are more likely to occur in early disease. Polyarticular disease is prognostic for progression of damage. Psoriatic arthritis may appear as a rapidly destructive arthritis described as arthritis mutilans. HLA-B*27 is associated with the development
As previously stated, Psoriasis is caused by a mistaken trigger in the Immune system. “Normally, T cells help protect the body against infection and disease.” (NIAMS, 2013) When the disorder triggers the immune system, it causes the T cells to activate and trigger other immune responses. This will develop the redness and scaling of the
This disease is partly due to a genetic and environmental factors(Y. Liu, J. G. Krueger et al 2007). Psoriasis can be categorized as mild, moderate and severe conditions. Mild psoriasis leads to formation of rashes and when it becomes moderate the skin turns into scaly. In severe conditions, the red patches may be present on skin surface and become itchy. This affects a person’s daily life including professional and social life. The normal mechanism of body is that it form new skin cells in every month to replace skin which is sheds or flakes off. But in psoriasis the new skin cells grow rapidly within days rather than weeks. This leads to accumulation of dead skin on the skin surface and resulting in thick patches of red, dry and itchy skin.
Yes, I believed that Biologics would be unaffordable to me. However I made some calls to The Psoriatic Foundation and had a rather encouraging discussion which them, however when I spoke directly to the Enbrel people I found they were far less encouraging. I tried to move my follow-up doctors appointment up, only to discover that they are closed on
Psoriasis was copied from the Greek word psora, which means “to itch” (Jean, 2011). Psoriasis is a chronic, long lasting autoimmune skin disease that disturbs the speed of the growth cycle in skin cells (Stress-Related Disorder Sourcebook, 2016). Normal, healthy skin cells replace dead skin cells every twenty-eight to thirty days (Langley, 2005). Skin is the largest organ in the body. It protects from the environment, regulates body temperature, helps coordinate immune system regulation, function of touch sensations, waterproof, and prevents toxin substances from entering the body (Langley,2010). Psoriasis effects greater than three percent