Running Head: Medical Discussion 1

Integumentary and Sensory Functions

Student’s Name

Institutional Affiliation

Course

Date

(Total Words: 1224)

Running Head: Medical Discussion 2

Integumentary Function

(Total 616 words)

Question 1

Psoriasis is strongly related to the immunological response of the T lymphocytes. From a clinical

perspective, psoriasis is divided into two major groups: nonpustular and pustular. The list of non

pustular psoriasis includes Vulgaris form, guttate, palmoplantar, psoriatic arthritis, inverse

psoriasis. On the other hand, pustular form includes vom Zumbusch type, impetigo

herpetiformis, and localized forms. Many of the patients who are predisposed to this disease

might be symptom-free for a long period of time until an environmental factor triggers it.

Examples of trigger factors include infections (skin infection or strep throat), cold and dry

weather conditions, injuries at the level of the skin, smoking, stress, alcohol consumption, some

medications such as the ones used to treat hypertension, withdrawal from systematic

corticosteroids drugs. (Sarac et al ,2016)

Question 2 and 3

The treatment of psoriasis must be individualized, carried out in relation to the severity,

form of the disease, topography of the lesions and the patient's response to treatment. There are

three main types of treatments: topical therapy, phototherapy and systemic therapy. Topical

treatment or local treatment is applied directly on the skin such as keratolytics. They are used to

remove scales. The most used are salicylic acid 3-5% or urea 10-15%. Another example includes

dematocorticoids. There are corticosteroids in local application. They have anti-inflammatory

and cytostatic action. Exposure to sunlight or ultraviolet light has favorable effects, which are

due to inhibition of DNA synthesis in the psoriatic epidermis.

Running Head: Medical Discussion 3

Photochemotherapy (PUVA) is based on the association of ultraviolet A with psoralens.

Under the action of ultraviolet radiation, they form stable bonds between the pyrimidine bases of

DNA strands and inhibit replication. It has a local immunosuppressive effect by acting on

Langerhans cells and lymphocytes. Psoralen can be administered locally or systemically.

Systemic treatment is indicated in severe types of psoriasis, especially in the arthropathic,

pustular or erythrodermic form and is administered orally or intravenously. Examples of drugs

include metrotreax, pyritrexin or cyclosporine. Mild emollients. Skin care with mild emollients

should be performed between treatment periods to prevent dry skin, which can lead to early

recurrence. The addition of 10% urea is helpful in increasing skin hydration. (Rendon,2019)

Question 4

It is essential to understand the patient's comorbidities and current treatment because some types

of drugs can actually make the symptomatology of psoriasis worse. For example, blood pressure

medications such as beta-blockers were linked to flares. Examples include atenolol, propranolol,

metoprolol. Another group of medications includes nonsteroidal anti-inflammatory drugs. They

are usually painkillers used to keep under control psoriatic arthritis or joint pain, but it can also

cause flare-ups—the drugs which were linked to skin manifestations include indomethacin and

naproxen. For patients who take mental health medicines such as clonazepam, diazepam,

alprazolam, they have a higher risk of severe psoriasis symptomatology. Due to that, it is

essential for the care provider to understand the patients' comorbidities to reduce the risk of flare-

ups. (Kim et al,2017)

Question 5
Running Head: Medical Discussion 4

The symptoms of the disease may vary depending on the type of psoriasis a person suffers from,

but may include one or more situations:

Red areas of skin, inflamed skin usually covered with silvery-white scales - this is the most

common form of plaque psoriasis. These areas can be painful and itchy. Itching can occur

anywhere on the body, including the genital area. Sometimes these areas crack and bleed.

Psoriasis can also affect the nails on the hands and feet. Discoloration and unevenness on the

surface of the nails can be symptoms of nail psoriasis. This can cause the nails to come off and

eventually fall out. Nails can shatter in some more severe cases of psoriasis.

Itchy areas on the scalp may also present white scales. (Nair et al,2020)
Running Head: Medical Discussion 5

References

Kim, W. B., Jerome, D., & Yeung, J. (2017). Diagnosis and management of psoriasis. Canadian

family physician Medecin de famille canadien, 63(4), 278–285.

Nair PA, Badri T. (2020) Psoriasis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls

Publishing; 2020 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK448194/

Rendon, A., & Schäkel, K. (2019). Psoriasis Pathogenesis and Treatment. International journal

of molecular sciences, 20(6), 1475. https://doi.org/10.3390/ijms20061475

Sarac, G., Koca, T. T., & Baglan, T. (2016). A brief summary of clinical types of psoriasis.

Northern clinics of Istanbul, 3(1), 79–82. https://doi.org/10.14744/nci.2016.16023

Running Head: Medical Discussion 6

Sensory Function

(Total 508 words)

Question 1

Based on the symptomatology of C.J, this is most likely a case of conjunctivitis. The conjunctiva

is a thin, transparent, well-vascularized membrane that lines the anterior surface of the eyeball

and the posterior face of the eyelids. Due to its location, the conjunctiva is exposed to the action

of microorganisms or exogenous harmful substances. Resistance to these aggressions is given by

tears that dilute and eliminate the infectious material, and through the content of lysozyme,

betalizine, IgA, IgG, prevents the growth and development of germs.Conjunctivitis is an

inflammatory condition of the conjunctiva of variable cause: bacterial, viral, allergic, irritating

factors. Conjunctivitis is the most common condition of the conjunctiva, its severity ranging

from mild conjunctival hyperemia with tearing, to very severe inflammation due to the

complications it can cause. The positive clinical diagnosis is based on subjective and objective

symptomatology, and the etiological diagnosis of certainty is established only by bacteriological,

virological and cytological examination of the conjunctival secretion. (Pippin,Lee,2020)

Question 2

Based on the clinical data presented, it would be hard to clearly state the pathology's etiology

clearly. Even so, the yellowish discharge confirms this is most likely a bacterial infection rather

than a viral one. The pathogen most frequently affects both the eye and the ear at once is

Chlamydia Trachomatis. Bacterial conjunctivitis represents 40% of the ocular infectious-

inflammatory pathology. The microbial agents involved can be varied, coming either from the

saprophytic flora of the conjunctiva and eyelids, or from the outside, by air, through direct
Running Head: Medical Discussion 7

contact with contaminated hands or objects, or from a clinically inapparent adjacent infection.

The onset is acute, unilateral, with bilateralization in 24 - 48 hours. The patient has itching,

foreign body sensation, stinging sensation under the eyelids, tearing. Objectively, it is

characterized by red eyes that can be associated with edema (swelling) of the eyelids, mucous or

purulent conjunctival secretion, sticking of the eyelids in the morning, on waking. Sight is not

affected. (Ryder,Benson,2020)

Question 3

The treatment of bacterial conjunctivitis is done with antibiotics that are administered locally in

the form of eye drops or ophthalmic ointment in the lower conjunctival sac. In most cases of

conjunctivitis in adults or children, treatment is initiated without examination of conjunctival

secretion. If the ophthalmologist wants to perform the culture, the antibiotic treatment is initiated

and then it is modified, if necessary, depending on the result of the antibiogram. No bandage will

be applied to the eye with secretion, which can lead to aggravation of the disease by stagnation

and development of germs as in a culture medium. Inadequate or insufficient treatment can lead

to important complications that can lead to severe reduction in visual acuity (eg, keratitis). Viral

and bacterial conjunctivitis are highly contagious, which is why it is important for the patient to

follow these prevention rules.

Some patients become infected through contact with people with conjunctivitis, directly or

through infected objects (pillow, towel, handkerchief). Others have contact with patients

suffering from upper respiratory tract infections. Very few contract the disease through infected

water in swimming pools. (Yeu,Hauswirth,2020)

Running Head: Medical Discussion 8

References

Pippin MM, Le JK.(2020) Bacterial Conjunctivitis. . In: StatPearls [Internet]. Treasure Island

(FL): StatPearls Publishing; 2020 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK546683/

Ryder EC, Benson S.(2020) Conjunctivitis In: StatPearls [Internet]. Treasure Island (FL):

StatPearls Publishing; 2020 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK541034/

Yeu, E., & Hauswirth, S. (2020). A Review of the Differential Diagnosis of Acute Infectious

Conjunctivitis: Implications for Treatment and Management. Clinical ophthalmology

(Auckland, N.Z.), 14, 805–813. https://doi.org/10.2147/OPTH.S236571