Question

M.M., a 35-year-old man, presents with complaints of several thick, well-defined erythematous areas on both his elbows and knees that have silvery scales on them. He complains of itching in these areas and that the areas bleed when he removes the scales. M.M. states that he has had these lesions for some time; however he has used over-the-counter hydrocortisone and some of his friend's triamcinolone 0.025% cream on them for itching. He feels that the lesions have gotten worse since he went on vacation in the Dominican Republic when he got "a pretty bad sunburn". His medical history is non-contributory. His only medications, besides topical corticosteroids, include a recent course of chloroquine for malaria prophylaxis during his recent travel. On physical examination, M.M. also has a few scattered, circumscribed, erythematous scaly plaques on the surfaces of both arms and legs and a dense scale on his forehead and scalp. Approximately 6% of his body surface (BSA) is estimated to be affected with psoriasis. The rest of M.M.'s physical examination and laboratory values are within normal limits. 4. How would you categorize M.M.s psoriasis? What is the potential cause of his psoriatic exacerbation? 20 points 5. suggest a drug therapy plan for M.M.'s psoriasis. 20 points

Answer 1

4. M.M's psoriais can be categorized as Chronic plaque psoriasis. Erythematous plaques with a silvery is a manifestation of this type of psoriasis.The potential cause of his psoriatic exacerbation is the sudden changes in the climatic zone, preparations for malaria(chloroquine for malarial prophylaxis) and sun burn have triggered the condition.

5.Firstly,creams and ointments that do not contain hormones can be given(salicylic ointment) along with antihistamines in the first month of treatment.Following that after inflammation gone, Daivonex can be given as it has active ingredient calcipotriol (vitamin D analogue), which deactivates T-lymphocytes and inhibits the growth of the keratinocyte layer.When relapses of the disease,Colloidin ointments/Kartalin's ointment can be given for softening of psoriatic plaques.