Full Answer Section

• Psoriasis Types:
  • Plaque Psoriasis (K.B.’s case):Most common type, with raised, red, scaly patches. K.B.’s widespread outbreak suggests plaque psoriasis.
  • Guttate Psoriasis:Small, red, teardrop-shaped lesions, often triggered by streptococcal infections.
  • Pustular Psoriasis:Pus-filled blisters on red, inflamed skin.
  • Inverse Psoriasis:Smooth, red, inflamed patches in skin folds (groin, armpits, genitals). K.B.’s groin involvement might be inverse psoriasis.
  • Erythrodermic Psoriasis:Severe form with widespread redness, scaling, and potential for life-threatening complications (not likely in K.B.’s case).

2. Treatment Options for K.B.:

Considering K.B.’s past success and current widespread outbreak, a multi-pronged approach is likely recommended:

• Topical Corticosteroids: High-potency may be used initially to reduce inflammation, but long-term use is not ideal due to side effects.
• Topical Calcineurin Inhibitors: Tacrolimus or pimecrolimus can be effective for long-term control with fewer side effects than corticosteroids.
• Topical Vitamin D Analogs: Can help slow skin cell growth and reduce inflammation.
• Phototherapy: Light therapy using ultraviolet B (UVB) radiation can be very effective for psoriasis.
• Oral or Injectable Medications: If topical options are not sufficient, K.B.’s dermatologist might consider medications like methotrexate or biologics that target the immune system.
• Non-pharmacological options:
  • Moisturizers:Regularly applied to keep skin hydrated and comfortable.
  • Stress Management:Techniques like yoga or meditation can help reduce stress, a known trigger.
  • Weight Management:If K.B. is overweight or obese, losing weight can improve psoriasis symptoms.

3. Importance of Medication Review:

A medication review is crucial to identify any potential:

• Drug interactions:New medications might interact with existing ones, worsening psoriasis or causing other side effects.
• Medications that can exacerbate psoriasis:Some medications, like beta-blockers or lithium, can trigger or worsen psoriasis.

4. Other Psoriasis Manifestations:

Psoriasis can affect other areas beyond the skin, including:

• Psoriatic Arthritis:Painful inflammation of joints.
• Psoriatic Nail Disease:Pitting, discoloration, and crumbling of nails.
• Psoriatic Eye Disease:Inflammation of the conjunctiva (eyelid lining) or other parts of the eye.

Conjunctivitis Case Study (C.J.)

1. Diagnosis:

Based on the symptoms (crusty discharge, conjunctival erythema, blurry vision), C.J. most likely has acute bacterial conjunctivitis.

• Rationale:Bacterial conjunctivitis is contagious and commonly presents with these symptoms. The presence of a throbbing earache suggests a possible bacterial upper respiratory infection (URI) that spread to the eye.

2. Identifying the Etiology (Cause):

Without further information, pinpointing the exact bacterial cause (e.g., Staphylococcus aureus, Haemophilus influenzae) is impossible.

3. Treatment Approach:

Given the suspected bacterial cause, the most likely initial treatment would be:

• Topical antibiotic eye drops:Target common bacterial pathogens causing conjunctivitis.