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Running head: PSORIASIS 1

Psoriasis

Student’s Name

Institutional Affiliation

PSORIASIS 2

Psoriasis

Introduction

Psoriasis is an illness whose symptoms are generally abnormal patches on the skin. The

disease is usually autoimmune. The types of the skin patches identified on the surface are often

itchy, scaly and red. This research project has been set to identify and analyze different ideologies

related with psoriasis skin disease. More significantly, the study has identified different types of

psoriasis disease, their causes, symptoms, and the possible curative and preventive mechanisms.

Some of the research queries that lead to the success of the project include but not limited to what

are the different types of the psoriasis disease? What are the causes of the respective kinds of the

psoriasis illness? What are the symptoms of the specific kinds of psoriasis illness? What are the

defensive mechanisms to the identified types of the psoriasis disease? What are the long-term and

the short-term treatment measures of the psoriasis disease identified? The research project made

use of different methods of data collection and analysis. The project utilized the qualitative

approaches in collecting and analyzing the information about the disease in question. The most

significant means of data collection employed were the use of structured questionnaires,

observation method, internet research, and interviews. The structures questionnaires were

administered to the nurses and the victims suffering from psoriasis disease. Internet research was

done majorly by visiting medical institution websites and literature sites presented by different

authors in the internet. Observation was the most accurate method of obtaining first-hand

information through viewing the color of the patches originating from the different categories of

the psoriasis disease. Depth interview was the often used method of getting information directly

from the patients and the medical professionals. The choice of the interviewers was strategically

done to avoid inconveniences of stressing the patients over personal experiences with the disease.

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Research Question

 What are the distinctive ideologies that characterize the patient’s knowledge and

perceptions towards psoriasis disease?

Objectives

 To identify different ideologies that exists among the societies pertaining psoriasis disease.

 To identify the different type of psoriasis disease

 To determine the causes of the defined categories of psoriasis disease

 To identify the symptoms of the different types of the psoriasis disease

 To develop different preventive measures of the psoriasis disease

 To establish the long term and short term curative mechanisms of the psoriasis disease

Research Contribution

It is imperative to note that the research focused on detailed discussion of the disease in a

process of fact-finding to identify the facts regarding the disease. The information obtained is

crucial in ensuring that measures taken to control the disease follow the right procedure to prevent

losses and other uncalled for incidences. This research is of fundamental importance not only to

the topic but also to the advanced nursing practice in question. This research has identified different

types of psoriasis disease and their specific preventive measures. As we all know, prevention is

better than cure in the recent times. By identifying the types and preventive measures of psoriasis

disease, the research has helped avoid the possible expenditures likely to be incurred in the

treatment procedures. Additionally, narrowing down to specific types of the disease will enhance

accuracy and reliability of the actions towards the prevention of the disease. Identification of the

symptoms in the early stages of the disease as explained within the research will prevent the

adverse effects of the disease on the skin. Unlike the other researchers who provide details about

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the treatment and the preventive measures only, this research has identified the possible causes of

specific types of the psoriasis disease make the preventive measures more reliable for they focus

on the causal agents more than the entire disease. In so doing, the defensive mechanisms likely to

be employed have a long-term impact. The project also identifies the curative measures of the

disease.

The failure of the prevention mechanisms does not present a barrier out of condition.

However, the study provides more advanced technical means to deal with such a fundamental

crisis. The report, therefore, acts as a guideline not only to the patients but also to the medical

experts who have limited or no information at all regarding the treatment approach to the disease.

The report was compiled following both the patient experiences and the professional’s knowledge

in the topic. Therefore, the details entailed in this document are essential and more diversified to

present tackle all the sectors related to the disease. The report compromises different perceptions

of the authors who documented their kinds of literature on the topic. The report, therefore, acts as

a summary of the diverse pieces of literature presented by different authors across the globe. The

study identifies the different shortages in the writings and makes perfections in the documented

data by summarizing the details on the topic in a clear and most precise manner that is

understandable across all levels of the academic professionalism. The information collected is

more of practical than the theoretical bit. Most of the methods used in data collection which include

but not limited to the interviews and the observation methods gives first-hand information which

is more reliable and accurate. Besides, the choice of experts to conduct the interviews ensured all

the areas required are exploited. The experts also ensured the information obtained is neither too

biased to demoralize the patients nor too friendly to ignore essential regions of the topic.

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Literature Review

Zangeneh, F. Z., & Shooshtary, F. S. (2013) outlines different types of psoriasis and their

possible modes of treatment. As described in the study, the disease is classified into different

categories which include and not limited to guttate psoriasis, inverse psoriasis, palmoplantar

psoriasis and pustular psoriasis. Further, Zangeneh, & Shooshtary (2013) presented the second

classification of the disease based on causative organism and the degree of destruction. As per the

designation, the disorder is divided into chronic psoriasis and plaque-like psoriasis. In the last

section of the study, the scholars revealed some of the significant causes of psoriasis. Based on the

chapter, the article present that psoriasis is the most prevalent disorder which is often caused by

inappropriate activation of the cellular immune system. The study identifies two significant

hypotheses beyond the development of psoriasis. The first cause is associated with excessive

replication and growth of skin cells. The second hypothesis perceives the disease to be an immune-

mediated disorder. Moreover, Zangeneh, & Shooshtary, (2013), provided different medication

option of the disease, psoriasis. Such treatment methods include and not limited to light therapy,

use of topical drugs, Phosphodiesterase inhibitors, and Oral or injected medications.

World Health Organization (2016), provided a review on global on psoriasis. In this

article, the scholars defined the disease as the chronic, painful, non-communicable and disabling

disorder which significantly diminishes the patient's quality of life and wellbeing. Besides, World

Health Organization (2016), reveals that the etiology of the disease is still unclear though evidence-

based practices have ever been linking it to genetic predisposition and overall immune system.

Similarly, the report documents some of the severe effects of the disease which include intense

physical pain, emotional discomfort, and social burden. Further, World Health global review

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provides several medication options for mitigating the signs and symptoms of psoriasis which

typically include systematic and topical therapies.

According to Kimball et al. (2014), psoriasis is typically associated with a combination of

behavioral risk factors which, in turn, predisposes its growth and development. Based on the

study, the scholars formulated a systematic research approach to study the primary causes and

treatment of patients with severe psoriasis disorder. In this context, the authors reviewed PSOLAR,

which was first introduced in 2007 to critically identify people living with psoriasis who are

eligible for being enrolled in systematic therapy. Finally, the study determined that the disorder

(psoriasis) primarily acts as the risk factor for cancer infection. Similarly, Kimball et al. 2014

revealed that there are increased rates of lymphoma particularly for individuals infected with

psoriasis.

Aghmiuni, & Khiavi, (2017), revealed several medicinal plants which are commonly used

in the treatment of different types of psoriasis. Based on the article, the authors identified the

components of Glycyrrhiza glabra (flavonoids and tannins) and those of Arctium lappa, Pinus

eldarica and Avena sativa to be more effective particularly in the treatment of skin lesions caused

by psoriasis. Similarly, presents that the provitamins such as vitamin A contain anti-oxidation

agents which, in turn, prevent damage to skin cells by such diseases as psoriasis and other allied

fungal diseases. Furthermore, the article depicts that such vitamin as E, B5, F, C, and D3 actively

participates in skin recovery, boosts the immune system, and relief the skin from instances of

inflammation.

Based on the study conducted by Young, Aldredge, & Parker (2017), it is evidential that

the primary care practitioners (PCPs), play an active role particularly in management and caring

patients who have psoriasis. Therefore, the study emphasis such professionals should, therefore,

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be knowledgeable and trained on practices encoded in providing nursing care to people living with

psoriasis. Besides, Young, Aldredge, & Parker (2017), suggests that the PCPs should be educated

on activities related to diagnosis and treatment of psoriasis. Furthermore, the review provided

primary care practitioners with premier education about psoriasis as well as its impacts social

wellbeing and quality of life. To efficiently meet the set objectives, the literature by Young,

Aldredge, & Parker (2017), revolves around such discussion topics as psoriasis epidemiology,

predisposing factors, differential diagnosis, disease components and approaches to control and

treatment. Further, Young, Aldredge, & Parker (2017), also presented the importance of staying

abreast of advances particularly in the process of understanding the available treatment options

and the pathogenesis of psoriasis.

Rønholt, & Iversen, (2017), conducted a study on long-term diagnosis in patients with

psoriasis. In this context, the scholars identified multiple traditional comorbid conditions which

include and not limited to the psychological disorders, inflammatory bowel disease, and psoriatic

arthritis. Besides, Rønholt, & Iversen, (2017), indicate that there is an increasingly higher

association between metabolic dysfunctions such as obesity and psoriasis disorder.

According to Gulliver, (2018), different biological methods for controlling psoriasis have

recently been introduced in the healthcare setting. Based on the study, the authors were interested

in describing the available biological therapies for psoriasis and their contribution in the mitigating

the contemporary challenge. To begin with, the article discloses that systematic treatment options

were primarily used in the treatment of the disease (psoriasis). Further, the review indicates that

significant improvements have been witnessed especially after the introduction of the concept of

T-cell activation and tumor necrosis factor-x inhibitors. Therefore, this article contains fertile

information regarding treatment and control for psoriasis. Consequently, it can primarily be used

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in the formulation of further research on the same topic. Similarly, new technologies should be

integrated to aid in achieving better results on biologically centered therapies.

Boutet et al. (2018), conducted a study w with the central objective of identifying the role

of the IL-23/IL-17 axis in the mitigation of psoriasis and psoriatic arthritis. Based on the study,

the concept of psoriasis is defined as a chronic and systematic inflammatory disorder which is

typically characterized by scaly skin plagues. Besides, the article presents that more than 30

percent psoriasis patients later develop psoriatic arthritis (PsA). In this context, Boutet et al. 2018

reveal the core features of psoriatic arthritis as continuous inflammation and damage of peripheral

joints. As described in the research, cytokines, which are members of IL-23/IL-17, are primarily

involved in the process of chronic inflammation of synovium especially in patients with psoriasis

disorders. Therefore, alternative studies should be erected to examine why IL-23/IL-17 actively

contribute to inflammation and damage of synovium. Besides, possible treatment interventions

should be established to counter the impacts of IL-23/IL-17 in damage and inflammation process.

Sarac, Koca, & Baglan, (2016), presented an overview of different types of clinical

psoriasis. In this context, the authors outlined that guttate psoriasis is highly prevalent in children

and young adults. Similarly, according to the review, it is evident that the disorder is closely

associated with the individuals with HLACw6 gene. On the other hand, Erythrodermic psoriasis

is seen to be related to general lessons all over the body. Other forms of a clinical disorder

described by the author includes and not limited to Palmoplantar psoriasis, Psoriatic arthritis (PsA),

localized pustular psoriasis and generalized pustular psoriasis. As presented in the study, the

information contained is highly beneficial to healthcare practitioners and primary care practitioners

in particular. Therefore, it is imperative to use the research in training and development programs

especially those for primary care practitioners. A review presented by US Food and Drug

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Administration (2013), gave an overview of all forms psoriasis and possible drugs that can be

administered to patients living with different types of psoriasis. Further, Irimie et al. (2015),

outlined the risk factors associated with psoriasis disorder. In this context, it concluded that

cardiovascular risk factors are highly related to victims with plaque psoriasis.

Methodology

This research project took a survey research design. The study involved looking for

relevant information about ideas such as the symptoms, causes preventive measures and curative

mechanisms of the different types of the psoriasis disease. The research surveys carried out were

mostly factual and exploratory. The surveys were exploratory because the topic under discussion

despite having been studied by different authors, the level of exploitation of the basic queries

regarding the subject in question is still inferior. The problem has not been studied clearly, and

therefore there is necessity to expand on the issue by filling the gaps presented by the literature

authors on the subject. The research was also factual because the type of the data collected was

first-hand information under the real-life circumstances. The aspect of reliability which is a crisis

originating from several survey research designs was thoroughly tackled in this study. Having

chosen on the exploratory and the actual survey research designs, the methods of data collection

and analysis solemnly depended on the type of research designs. The approach employed in the

data collection and analysis was a qualitative method having recognized that the research

reacquires survey design. The importance of using qualitative methods of research over the

quantitative methods of research design is the inability to convert the information on the topic into

binary formats that would be analyzed using statistical methods such as regression analysis. The

importance of the qualitative analysis is the ability to explain the behavior of the individuals,

desires and feelings regarding the topic which is not only necessary for the study but also hard to

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be presented by the quantitative methods of data analysis and data collection. Regarding the factual

design that popped into the plan, the methods of data collection included observation, interviews,

and questionnaires. The exploratory research design came out as a result of the internet research

method.

As earlier mentioned, this research used both the secondary and the primary methods of

data collection. The secondary data involved data collected from already published sources which

were majorly the internet literature regarding this research. The fundamental techniques involved

observation, interviews, and questionnaires. An observation was necessary to view especially the

appearance of the patches on the skin. The interviews were semi-structured to maintain the

interviews on the critical areas of the topic. Some of the questions delivered were open-ended

whereas the others were closed. Similarly, the research project used questionnaires where some

queries were open-ended while others closed just like in the interview. Both interviews and

questionnaires were presented to the patients and the medical professionals on the topic. Some of

the research questions aimed at determining the fundamental areas mentioned within the research

objectives. The areas include but not limited to determining the different types of psoriasis disease,

symptoms, causes, preventive measures and the curative mechanisms of the disease.

Regarding the sampling method, choice of the sample population was critical for it

determined the accuracy, reliability, and validity of the data collected. The research, therefore, had

a significant implication on the research quality. The primary participants in the study were

medical professionals and the patients with the disease. From a population of five hundred medical

experts, only ten were selected as the sample population. Otherwise, fifteen patients were selected

as a sample population from the population size of nine hundred and fifty victims. The importance

of choosing the sample population was to save on the time taken in conducting the interviews.

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Regarding the validity and reliability of the data collected, the information is more valid because

it made use of different sources which were more primary and factual.

The variables in the research were the different areas regarding the psoriasis disease. The

areas were not compatible although in some circumstances the causes of the condition determined

the preventive measures likely to be undertaken. In other situations, the type of the disease

determined the most appropriate treatment methods to be employed. Finally, the symptoms of the

condition established the nature of the disease in question. However, more importantly, was to

exploit the types, cause, symptoms, preventive measures and the treatment of the psoriasis disease.

The institutional review board was designed to protect the welfare of the individuals

regarding the research projects. The committee ensures individuals are protected from harm by

reviewing the research processes and methods and ensuring they are ethical according to the

research regulations. The committee always carries out a risk factor analysis in determining the

necessity of completing research. Following this research, ethical issues were put into

consideration while conducting the research project. Firstly, the type of interviewers chosen for

the study is experts who take into account the significance of keeping the privacy of the patients.

Besides, the collection of research data was legally done through permission to access the pieces

of literature of the different authors on the internet. Also, the treatment and prevention methods

suggested in the study report are legal and approved by the committee in different research pieces

of literature presented on the internet for reference. Some of the treatment methods have been fully

supported and experimentally used in the medical institutions by professionals with expertise and

adequate knowledge regarding the topic of study.

However, the research project conducted has got challenges which need to be completed.

The research project encountered problems such as the time challenge and limited word count

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which made the exploitation of the areas of study more difficult. The kind of data presented in the

research project is limited to a few types of psoriasis instead exploiting all the over eighty varieties

of psoriasis disease. My suggestion to the future researchers is to expand on the topic by discussing

in detail specific types of the psoriasis diseases, specific causes, symptoms, preventive

mechanisms and the treatment of the conditions. Another suggestion to the future researchers to

include the quantitative approach of data collection and analysis to identify the possible numerical

simplifications of the data collected about the topic. Additionally, statistical data is necessary for

evidence about the data collection methods to the future researchers.

Data Analysis

Following the data collected during the project, several conclusions can be drawn. The

relevancy of the information is depicted in this section of the project. This section provided a

summary of the most significant data relevant to the problem in question. As earlier mentioned,

psoriasis is a skin disease characterized by red patches on the body skin. The identification of the

red patches came out as a result of observing the sample population of the victims. As identified

from the different literatures on the internet, psoriasis varies in strength from small patches to

medium and finally the large patches. There exist more than eighty varieties of the psoriasis illness

as obtained from the sample population of the medical experts. However, this research was more

focused on the five major varieties of the condition which are plaque, nail, guttate, inverse and

pustular psoriasis. Plaque psoriasis is characterized by dry, raised and red patches on the skin often

covered with a silvery scale. The patches vary in size from large to small and can occur anywhere

on the skin including the genital organs and the soft tissues like within the mouth. Nail psoriasis

has an enormous impact on the nails. The disease is characterized by abnormal nail growth. The

nails affected are both fingernails and the toenails. Under severe stages, the nails may decolorize,

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separate from the nail bed and finally crumble. Guttate psoriasis often affects the young adults and

children. Bacterial infections are majorly the causal agents that trigger the condition. The disease

is characterized by minute, water-drop-shaped scalywater-drop-shaped scaly patches on the legs,

trunk, arms and the scalp. The conditions occur ones and disappear by itself. However, repeated

episodes of the disease may also occur in other cases. Inverse psoriasis often affects the light skin

parts like under the armpits, under the breasts, in the groin and around the genitals. The illness

entails symptoms such as smooth red patches, inflamed skin usually worse under conditions such

as sweating and friction. The illness is also triggered by fungal infection. The final type of psoriasis

under our study is the pustular psoriasis. The condition is usually very uncommon. The disease is

characterized by widely spread red patches on the fingertips, hands, and feet. The condition

develops at a very high speed where pus-filled blisters appear before the skin becomes red and

tender. The condition may also disappear in a very short time period but the under severe

conditions may cause chills, fever, adverse itching and diarrhea.

The impacts of the psoriasis disease as obtained from the sample population of the victims

are very severe. Firstly, the disease leads to pain and discomfort. Secondly, the condition makes

the patients encounter difficulty in performing the daily activities. The disease comes with the side

effect of psychological trauma to the patients. The patients become more concerned with the color

of their skin. In summary, the condition comes up with joint problems like pain, swelling, and

inability to tackle routine operations.

The cause of psoriasis as obtained from the medical professionals is not entirely determined

but is most likely to be associated with immune deficiency. The primary cells related to the

problem include the T cells and the neutrophils white blood cells. The disease is, therefore,

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associated with the viruses and bacteria. Availability of the psoriasis disease triggers the T cells to

attack the healthy skin making the condition worse.

Many conditions trigger psoriasis. Such conditions include stress, smoking, vitamin D

deficiency, excessive alcohol consumption and injury on the skin. Some of the lesions on the skin

include cuts and scrape, severe sunburn and bug bite. Some infections like strep throat and skin

infections also may trigger the occurrence of psoriasis. Finally, the disease may be triggered by

some medications such as lithium, anti-malaria drugs, and iodides. The risk factors for the disease

include smoking, obesity, stress, bacterial and viral infections and family history.

The diagnosis of psoriasis illness is usually straightforward. The doctor has two approaches

to diagnosing the disease as from the details obtained from the medical experts. The first approach

is by examining the skin after viewing the medical history of the patient regarding the disease. The

second approach is by taking a skin biopsy. The second approach very rarely used. The medical

doctor rarely takes a sample of the skin biopsy which is usually examined through the microscope

to realize the type of the psoriasis disorders. The treatment of the disease reduces the inflammation

and makes the skin clear. The treatment approach can be subdivided into three namely the topical,

light therapy and the oral or injected medication.

Recommendations

Following the problems and the challenges encountered during this research, I recommend

several actions to the future researchers on the topic. Firstly, provide the best time limit for a

detailed study on the subject. Secondly, the researchers should allow for a more extensive word

count that would offer detailed work on the topic. The future researchers also need to combine

both the qualitative approach and the quantitative approach in the study to provide statistical

evidence to the data collection methods for reliability and accuracy.

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Conclusion

In conclusion, the impact of the psoriasis disease has been a significant side back to the

success of the healthcare sector. It's therefore essential to further this research in reducing the crisis

which has extended its supremacy into the economic development of nations across the globe. This

research is necessary for depicting the causes of the diseases, symptoms, preventive measures and

the curative measures. However, the study requires development especially in other varieties of

the psoriasis disease which are not tackled in the project.

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References

Aghmiuni, A. I., & Khiavi, A. A. (2017). Medicinal Plants to Calm and Treat Psoriasis Disease.

In Aromatic and Medicinal Plants-Back to Nature. InTech.

Boutet, M. A., Nerviani, A., Gallo Afflitto, G., & Pitzalis, C. (2018). Role of the IL-23/IL-17 axis

in psoriasis and psoriatic arthritis: The clinical importance of its divergence in skin and

joints. International journal of molecular sciences, 19(2), 530.

Gulliver, W. (2018). Long‐term prognosis in patients with psoriasis. British Journal of

Dermatology, 159(s2), 2-9.

Irimie, M., Oanta, A., Alexandrina Irimie, C., Gyula Fekete, L., Ioan Minea, D., & Pascu, A.

(2015). Cardiovascular risk factors in patients with chronic plaque psoriasis: a case-control

study on the Brasov County population. Acta Dermatovenerologica Croatica, 23(1), 28-

28.

Kimball, A. B., Leonardi, C., Stahle, M., Gulliver, W., Chevrier, M., Fakharzadeh, S., ... &

PSOLAR Steering Committee. (2014). Demography, baseline disease characteristics and

treatment history of patients with psoriasis enrolled in a multicentre, prospective, disease‐

based registry (PSOLAR). British Journal of Dermatology, 171(1), 137-147.

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

psoriasis. Northern clinics of Istanbul, 3(1), 79.

US Food and Drug Administration. (2013). The voice of the patient. A series of reports from the

US Food and Drug Administration’s (FDA’s) patient-focused drug development initiative.

Chronic fatigue syndrome and myalgic encephalomyelitis.

World Health Organization. (2016). Global report on psoriasis. 2016. WHO Library Cataloguing-

in-Publication Data.

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Young, M., Aldredge, L., & Parker, P. (2017). Psoriasis for the primary care practitioner. Journal

of the American Association of Nurse Practitioners, 29(3), 157-178.

Zangeneh, F. Z., & Shooshtary, F. S. (2013). Psoriasis—types, causes and medication.

In Psoriasis-Types, Causes and Medication. InTech.

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