Psoriasis Case Studies Essay

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Case #3: A 29-year-old male with psoriasis and joint symptoms has been referred to physical therapy for pain management and an exercise program. He has a 7-year history of plaque psoriasis, a 7-year history of psoriatic arthritis, particularly in the hands, and 15% body surface area involving scalp, trunk, and limbs. He is obese with a BMI of 31 and is being followed closely due to being at risk of metabolic syndrome. He is on 15 mg/week of methotrexate.
The patient’s diagnoses of psoriatic arthritis and metabolic syndrome:
Psoriatic arthritis:
It is autoimmune disorder which occurs when our body immune system begins to attack healthy cells and tissue. This abnormal immune response causes overproduction of cells and inflammation
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They are common causes and risks factors for cardiovascular system. 5, 8
Genetics: Family history of type 2 diabetes, hypertension, hyperlipidemia, obesity. They are more inclined to develop insulin resistance which causes metabolic syndrome. Some people like African-Caribbean, Asian, Hispanic (Latin American) have a higher risk of developing metabolic syndrome. 4, 6
Obesity: sedentary life style, lack of exercises lead to obesity which is known factor to promote insulin resistance. Fat deposition also takes main part in insulin resistance and etiology of metabolic syndrome. High lipid concentration in the muscles of upper body-obesity is more strongly correlated to insulin resistance. Visceral obesity is a common example in obesity patient. 5, 6, 8
Diet: High fat (carbohydrate foods) foods, atherogenic and cold drinks are main factors of increasing fat and obesity. Cold drinks have more sugar concentration which leads to insulin resistance.
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But some people have high blood glucose level or high blood pressure. But some sign and symptoms of metabolic syndrome should have present in the patient.
Obesity: If patient have large waist circumference or apple shape body, it’s called “central or abdominal obesity”. Waist circumference can vary in gender, height and weight in individual patient. In men, waist circumference should be at least 40 inches and 35 inches in women.
High blood pressure: High blood pressure at least 130/85mmhg usually but it has no sign and symptoms except in early stage. Patient may have dull headache, more nosebleeds or dizzy spells. 6, 11
High blood glucose levels: Patient’s body is unable to control insulin resistance. But fasting sugar level should be at least 5.6mmol/L. high blood glucose level’s symptoms include increased thirst, weakness, fatigue, blurred vision, increased urination in night. 6, 11
Abnormal cholesterol: Hypo density lipoprotein level less than 40 mg/dL and women less than 50 mg/dL. 6
High blood triglycerides: They are form of circulating fats and levels of triglyceride should be at least 150mg/dL or 1.7mmol/L. 11
Medical treatment:
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