• “When did you first notice the changes on your skin? Did it occur suddenly or gradually?”
• “Tell me the time of recurrence?”
• “Do you have any pain, itchiness, bleeding, or color changes on the patches? If you have any pain, tell me the location, severity, timing, and quality? How do you rate it on the scale of 0-10, 0 being no pain and 10 being extremely painful?”
• “Does this skin problem occur with season or climate change?”
• “Are the patches localized on your scalp only or they also occur on other part of your body such as on the back, buttocks, or the extremities?”
• “Does the skin issue occur when you …show more content…
Psoriasis is an immune-mediated chronic inflammatory disorder that is associated with both genetic and environmental factors. It is characterized by increased epidermal cell turnover, increased number of epidermal stem cells, and abnormal differentiation of keratin expression leading to thickened skin with copious scale (Ball, Dains, Flynn, Solomon, & Stewart, 2015). Psoriasis presents as symmetrical, sharply demarcated, erythematous, dry, scaling, pruritic plaques affecting the skin (Gupta, Simpson, & Gupta, 2016). It is often disfiguring, painful, and itchy. It often appears on scalp, lower back, buttocks, elbows and knees. It is associated with multiple comorbidities such as hypertension, diabetes, and obesity. It is also associated with psoriatic arthritis that leads to pain and swelling in the joints in about 30% of people (National Psoriasis Foundation, 2015). Although psoriasis is not completely curable, it can be managed and controlled by avoiding triggers, eating healthy diets and