Psoriasis

WHAT YOU SHOULD KNOW:

• Psoriasis (so-RI-ah-sis) is a long-term skin disease. With psoriasis, skin cells grow faster and shed in just a few days, which is quicker than normal. This abnormal growth causes a buildup of skin cells and forms large plaques (patches of scales). Psoriasis most often forms on the elbows, knees, legs, scalp, back, face, palms, and soles of the feet. The blood supply in the skin may also be affected and cause redness and inflammation (swelling). It is more likely to occur if you have a weak immune system or another family member has psoriasis. Certain conditions, such as infections, certain medicines, stress, or skin damage may cause your psoriasis to flare-up.
  
  
• The signs and symptoms of psoriasis usually depend on the type of psoriasis you have. Most people have red, raised, patches covered with silvery scales on their skin that tends to bleed when removed. Skin biopsy and blood tests may be done to help diagnose psoriasis. Treatment is aimed at clearing the skin of plaques and scales and decreasing symptoms. You may be treated with phototherapy, medicines such as steroids, or surgery. With treatment, such as medicine and phototherapy, complications may be prevented and your psoriasis may be controlled.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Treatment for psoriasis may have unpleasant side effects. Some medicines may cause burning, redness, irritation or stinging of skin, drowsiness, high blood pressure, or kidney problems. Without treatment, psoriasis may cause severe itching, easy bleeding, swelling, and infection. Ask your caregiver if you are worried or have questions about your skin disease, medicine, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Medicines: You may have one or more of the following:

• Topicals: Topicals are medicines like ointments, creams, and pastes that are put on your skin.
  
  
  • Anthralin: This medicine decreases swelling and excess skin cells that form scales.
    
    
  • Moisturizers: These soothe your skin by keeping it moist and preventing skin dryness.
    
    
  • Salicylic acid: This peeling agent helps decrease scaling of the skin and scalp.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.
    
    
  • Tape or occlusive dressings: These are tapes or bandages that already have medicine on them. They are placed tightly over flare-ups and are left in place for 1 to 7 days.
    
    
  • Tar preparations: These medicines decrease your itching and help rashes heal. These may come in the form of shampoos, creams, or bath oils.
    
    
  • Vitamin D and retinoids: These are vitamin-based creams that are used to clear plaques.
  
  
• Systemics: These medicines are used to treat serious types of psoriasis and may be given orally or through your IV. Systemic medicines affect the entire body and regulate the immune system.
  
  
• Other medicines: The following medicines may also be given to ease your symptoms:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Anti-itching medicine: Caregivers may give you medicine to help keep your skin from itching. This medicine may be given in an IV, as a shot, by mouth, or as a skin lotion. Sometimes this medicine can make you sleepy.
    
    
  • Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

Tests: You may need one or more of the following:

• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Joint x-ray: This is a picture of the bones and tissues in your joints. Joints are the places in your body where two bones meet. You may be given dye as a shot into your joint before the x-ray. This dye will help your joint show up better on the x-ray. A joint x-ray with dye is called an arthrogram.

Treatment options: You may need one or more of the following:

• Phototherapy: You may need ultraviolet (UV) light treatments if your psoriasis is very bad. Your skin may be exposed to a bright UV light for the period of time your caregiver prescribes.
  
  
• Psychotherapy: This helps you manage or control stress by learning to relax, such as by deep breathing exercises or meditation. Biofeedback and muscle relaxation exercises may also help you relax. Your caregiver may include your family or people that are close to you during these meetings.
  
  
• Surgery:
  
  
  • Cryosurgery: During cryosurgery, a chemical called liquid nitrogen is put on the area to be removed. This freezes and kills the tissue. The dead tissue later falls off. Once the tissue thaws, the area may hurt and swell for a short time. You may need cryosurgery more than once.
    
    
  • Dermatome shaving: Caregivers may remove some or all of the layers of your skin affected with psoriasis. This is done by shaving the skin using a knife called a dermatome.
    
    
  • Laser surgery: A narrow beam of light is used to kill the overreactive cells that are causing the scaling and inflammation (swelling).

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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