NUR 631 Topic 14 DQ 2

Sample Answer for NUR 631 Topic 14 DQ 2 Included After Question

Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

  1. What is the pathological process in the development and presentation of eczema versus psoriasis?
  2. Discuss the pathological process and presentation of atopic dermatitis and its relationship to asthma and allergies.

A Sample Answer For the Assignment: NUR 631 Topic 14 DQ 2

Title: NUR 631 Topic 14 DQ 2

What is the pathological process in the development and presentation of eczema versus psoriasis?

Maintaining skin integrity is important for overall health. The skin protects us from environmental hazards, allows us to sense temperature, maintains homeostasis, and creates an added layer of protection from pathogens. Certain dermatological conditions such as eczema and psoriasis create a disruption in the skin barrier. Eczema is a condition of the skin in which there is an inflammatory response either from a genetic or environmental allergen. Eczema is characterized by pruritus, lesions with indistinct borders, papules, erythema, and scales, it may also be chronic, acute, or subacute (McCance et.al, 2019). Eczema is directly related to an underlying cause.

To compare, psoriasis clinically appears the same as eczema, it is however an inflammatory disorder. Psoriasis is a skin disorder that is triggered by some kind of physical injury such as streptococcal infections, medications, and the Koebner phenomenon (McCance et.al, 2019). When psoriasis is triggered, the inflammatory cascade is activated and it heavily involves interactions between macrophages, natural killer cells, fibroblasts, T helper cells, and regulatory T cells, it is important to note that psoriasis is a T helper cell-mediated autoimmune disease (McCance et.al, 2019). Both skin disorders require overtime observation for chronic conditions and exacerbations and medicated ointment, psoriasis treatment may require immunomodulatory. 

Discuss the pathological process and presentation of atopic dermatitis and its relationship to asthma and allergies.

Atopic dermatitis (AD) is a form of eczema and a chronic skin inflammatory disease. The pathophysiological process behind AD begins with genetic and environmental factors. Typically, in AD, patients have an impaired skin barrier, either from trauma or cuts, and this leaves the skin susceptible to environmental irritants and allergens leading to dry, itchy, and inflamed skin (Kolb & Ferrer-Bruker, 2022). The impaired barrier of the skin is caused by decreased levels of ceramides (moisture barrier), leaving open areas for irritants and allergens, which causes an overactive Th2 response, and an increase in interleukin 4 and 5 cytokines in acute conditions, and Th1 response in chronic conditions (Kolb & Ferrer-Bruker, 2022).

AD’s relationship with asthma is interchangeable, if there is an “atopic triad”, this means the patient is experiencing an acute condition of AD, allergic rhinoconjunctivitis, or asthma, they may start all together or one by one, mainly because it is the same pathological process in response to an allergen ( Kolb & Ferrer-Bruker, 2022). and AD may flare up in response to environmental allergens such as pen dander, fragrances, plants, clothes, foods, etc. 

References:

Kolb L, Ferrer-Bruker SJ. Atopic Dermatitis. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448071/

McCance, K. L., Huether, S. E., Brashers, V. L., Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children (Eighth ed.). Elsevier.

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A Sample Answer For the Assignment: NUR 631 Topic 14 DQ 2

Title: NUR 631 Topic 14 DQ 2

Eczema (atopic dermatiti):

Pathology-

Immunological Dysregulation: Eczema is primarily driven by an abnormal immune response and produces inflammation in the skin.

Barrier Dysfunction: There is a compromised skin barrier function in eczema patients.

Genetic Predisposition: Eczema often runs in families and has a strong genetic component. Mutations in genes related to the skin barrier function and immune response contribute to its development.

Allergic Sensitization: Allergens, such as pollen, dust mites, and certain foods, can trigger an allergic response in individuals with eczema, leading to skin inflammation and itching.

Th2 Immune Response: Eczema is associated with an overactive Th2 immune response. This contributes to the inflammation and itching characteristic of eczema.

Presentation-

Eczema typically presents as dry, itchy, inflamed skin with redness, swelling, and sometimes oozing or crusting. The affected areas can vary widely and may include the face, hands, elbows, knees, and other body parts. Scratching the affected areas can worsen the condition and lead to more inflammation and potential secondary infections.

Psoriasis:

Pathology-

Immune System Activation: Psoriasis is an autoimmune disorder causing rapid skin cell turnover and inflammation.

Hyperproliferation of Keratinocytes: In psoriasis, there is an overproduction of skin cells (keratinocytes) in the epidermis. These cells accumulate on the skin’s surface, leading to the formation of raised, scaly patches known as plaques.

Cytokine Release: Immune cells release inflammatory molecules called cytokines, such as tumor necrosis factor-alpha (TNF-alpha) and interleukins, which contribute to the inflammatory response and skin cell turnover.

Genetic Factors: Genetic predisposition plays a significant role in psoriasis. Certain genes are associated with an increased risk of developing the condition.

Environmental Triggers: Factors such as stress, infections, and certain medications can trigger or exacerbate psoriasis flare-ups.

Presentation-

Psoriasis lesions are distinct from eczema and are characterized by well-defined, red, raised plaques covered with silvery-white scales. These plaques often appear on the elbows, knees, scalp, lower back, and other areas. Psoriasis can also affect nails, joints (psoriatic arthritis), and other body parts.

Nemeth V, Evans J. Eczema. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538209/

Rendon, A., & Schäkel, K. (2019). Psoriasis Pathogenesis and Treatment. International journal of molecular sciences20(6), 1475. https://doi.org/10.3390/ijms20061475

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.