Psoriasis is a disorder caused by?

AIIMS Rishikesh NO - 2019

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Rishikesh NO - 2019

Explanation

Psoriasis is fundamentally an inflammatory autoimmune disease where the body's immune system attacks its own tissues.
The core of the disease involves immune cells like T-cells and dendritic cells being activated by self-antigens, leading to the release of inflammatory cytokines.
These cytokines cause hyperproliferation of keratinocytes (skin cells), resulting in the characteristic thick, scaly plaques.
This autoimmune process is the direct mechanism causing the signs and symptoms of psoriasis.

Option A: While psoriasis has a strong genetic component and often runs in families, heredity is a predisposing risk factor, not the direct cause. The disease mechanism itself is autoimmune.
Option C: Viral infections do not cause psoriasis. However, certain viral infections can act as triggers, causing a flare-up of the condition in individuals who are already predisposed.
Option D: Bacterial infections are not the cause of psoriasis. A specific type of psoriasis, guttate psoriasis, is often triggered by a streptococcal bacterial infection (like strep throat), but the infection is a trigger, not the underlying cause of the autoimmune condition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Psoriasis as background academic context rather than a clinical decision trigger.
Understanding that psoriasis is an autoimmune disease, not a contagious infection, is crucial for patient education. Nurses must reassure patients and their families that the condition cannot be spread to others.
Nursing care involves educating patients on identifying and avoiding personal triggers (like stress, certain medications, or infections) that can cause flare-ups.
What if? A patient with psoriasis develops swollen, painful joints. This is a critical sign of psoriatic arthritis, a common comorbidity. The nurse's priority is to document these new symptoms and ensure the patient is evaluated by a physician or rheumatologist, as systemic treatment will be required to prevent joint damage.

How to Approach the Question

First, identify the core of the question: it asks for the direct 'cause' of psoriasis.
Analyze the options to differentiate between a cause, a risk factor, and a trigger.
Recall the pathophysiology of psoriasis. It involves the immune system attacking the skin.
Evaluate 'Autoimmune'. This describes the disease mechanism where the body attacks itself, which is the direct cause of the symptoms.
Evaluate 'Hereditary'. This is a risk factor that makes someone susceptible but doesn't cause the disease to actively manifest without an autoimmune process.
Evaluate 'Viral' and 'Bacterial' infections. These are known triggers that can provoke a flare but are not the root cause of the chronic condition. Therefore, 'Autoimmune' is the most accurate and fundamental cause.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1908-1910