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Psoriasis is a chronic autoimmune disease that triggers the rapid build-up of skin cells. Deep in the skin, the skin cells expand and eventually rise to the surface and therefore fall off. The build-up of the cells gradually creates the whitish-silver colored scaling on the surface of the skin that grows in red patches, dense and often they may crack and bleed. Typically, on joints such as knees and elbows and other parts of the body, the scales grow. The disease transforms skin cells from individuals into overachievers that grow faster than normal skin cells, creating itchy patches.

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Psoriasis is activated by risk factors and causes, according to studies. The genes and immune system of a person cause psoriasis because the tiny bits of DNA genes instruct the cells that help control the body. Therefore, since they are mixed up, a person with psoriasis interferes with the genes, so instead of the genes that protect the body from invaders as they are meant to do, they appear to stimulate the inflammation, thereby turning the skin cells on the overdrive. Another consideration is smoking, as lighting doubles the chance of developing psoriasis, making it impossible to get rid of the symptoms. Psoriasis is caused by hormonal changes during puberty, pregnancy and menopause. In addition, the chronic disease may be triggered by some medications such as lithium, certain antimalarial drugs (Koran, 2020).

The common signs and symptoms of psoriasis differ depending on the type of psoriasis one suffers from. They include: red, inflamed skin rashes or patches that are covered with loose silver-colored scales that expand and blend into each other, thus covering wide areas, scaly plaques on the scalp itching, burning or soreness, swollen and rigid joints, rough, broken skin that itches or bleeds, discoloration and pitting of the finger nails and toe nails as the nails begin to crumble or crumble.

 According to Weldment al, fibrocystic breast disease is a fluid-filled condition with circular or oval cysts and fibrous tissue grows on the breasts, rendering them tender and lumpy in women. In certain women, the breasts become sore and usually encountered on the upper, outer region of the breast, thereby caused by the estrogen hormone. Fibro adenomas are solid, non-cancerous lumps of the breast that occur in women. With a well-developed shape, the breasts become solid, smooth, rubbery or rough. They are usually painless, so when examined, a person feels like a marble in the breasts that passes effortlessly under the skin. As they differ in size, they can expand or shrink on their own. As they enter and destroy the underlying tissue, which is most common in women, malignant tumors are cancerous and violent. If a tumor is found to be malignant, then the person suffers from breast cancer or another type of cancer. It is advisable, however, for a biopsy to be performed on a suspicious lump to determine whether it is a tumor or malignant (Waldman et. al 2019).

References

Koran, N. J. (2020). Management of psoriasis as a systemic disease: what is the evidence? British Journal of Dermatology182(4), 840-848.

Waldman, R. A., Finch, J., Grant-Keels, J. M., Stevenson, C., & Whitaker-Worth, D. (2019). Skin diseases of the breast and nipple: benign and malignant tumors. Journal of the American Academy of Dermatology80(6), 1467-1481.

Edited by Beltran, Lioydis on Jan 19 at 12:17pm

REPLY 2

Psoriasis is “a hereditary chronic inflammatory skin disease with environmental triggers.  Plaque psoriasis is a raised, scaly, erythematous patch with silvery scales, often pruritic and painful.  Occurs on scalp, extensor surfaces of knees and elbows, lower back.  Accompanied by nail pitting, onycholysis.” (Jarvis, 236, 2020).  There are different types of psoriasis, but the most common type is plaque psoriasis.  Things that put people as risk for developing psoriasis are family history, some types of infections, certain medicines, smoking, and obesity (NIH, 2020).  Signs and symptoms include patches of thick, red skin with silvery-white scales that itch or burn, dry cracked skin that itches or bleeds, and thick ridged, pitting nails.  The symptoms could come and go.  According to the National Institute of Health (NIH) because psoriasis is an inflammatory disease it can increase one’s risk of developing psoriatic arthritis, heart attack, or stroke.  (NIH, 2020).

            Fibrocystic Breast Disease (Benign Breast Disease) is when there are multiple tender masses that occur usually between the ages of 30-55 years of age and decrease after menopause.  This comes with multiple symptoms and physical findings such as swelling and tenderness, nodularity, dominant lumps (including cysts and fibroadenomas), nipple discharge (including intraductal papilloma and duct ectasia), infections and inflammations (including subareolar abscess, lactational mastitis, breast abscess, and Mondor disease) (Jarvis & Eckhardt, 18 (399), 2020). 

            Fibroadenoma’s are benign masses that are most commonly self-detected in late adolescence and early adulthood.  From 15-30 years of age but an occur up to 55 years of age.  It is a solid nontender mass that is firm, rubbery, and elastic.  They are round lobulated and about 1 to 5 cm (Jarvis & Eckhardt, 18 (399), 2020).  They are freely moveable, slippery, and can easily slide through tissue.  According to Jarvis there usually isn’t any axillary lymphadenopathy.  It’s diagnosed by breast exam, ultrasound, and needle biopsy.  Surgery is usually reserved for masses >5cm that are continuously enlarging, well defined, multiple masses, or if they are suspicious.  They are usually non tender and usually non tender (Jarvis & Eckhardt, 18 (399), 2020). 

            Breast Cancer is a “solitary, unilateral, 3-dimensional, usually non tender mass.  Solid, hard, dense, and fixed to underlying tissues or skin as a cancer becomes invasive.  Borders are irregular and poorly delineated.  Grows constantly.” (Jarvis & Eckhardt, 18 (399), 2020).  This requires diagnostic mammogram for those over age 30.  It is found mostly in the upper outer quadrant and found in women between the ages 30-80 years of age.  As cancer advances, signs include firm hard irregular axillary nodes; skin dimpling; nipple retraction, elevation, and discharge.  These are serious and needs early treatment.  It is important to educate patients on how to perform self-breast exams and regular mammograms as recommended by there healthcare provider.  Women need to inspect breasts, supraclavicular and infraclavicular areas, palpate the axillae and regional lymph nodes, and an actual physical exam including nipples areolae including tail of Spence.  As healthcare providers it is very important to not only educate your patients but also to educate them on how to perform the self-exam.   

Resource:

Jarvis, C. & Eckhardt, A., (2020).  Physical Examination & Assessment 8th Edition. Elsevier

copyright.  Skin, Hair, and Nails. 13(236). Breasts, Axillae, and Regional Lymphatics. 18 (399).

National Institute of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin

Disease. (2020). Psoriasis. Retrieved January 18, 2021 from Psoriasis Types, Symptoms & Causes | NIAMS (nih.gov) (Links to an external site.).

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