A critical appraisal of the assessment and management of psoriasis

Psoriasis affects a substantial number of the UK population. The chronic inflammatory skin disease that typically follows a relapsing and remitting course, resulting from the abnormal activation of T cells and associated increase in cytokines in affected tissues, can transpire at any age (Gould and Dyer, 2011). Plaque psoriasis is by far the most common type of the disease making up 90% of all cases and can result in all of functional, psychological and social morbidity (Basavaraj et al, 2011). Moreover, psoriasis has been linked with an increased risk of developing cardiovascular disease. There are a considerable amount of treatment options available for psoriasis, resulting in variance in practice within primary care, particularly concerning when to refer, drug monitoring and psychological support (Murphy and Reich, 2011). This is important to recognise within the paramedic profession as there is now an increased responsibility for paramedics to discharge patients within their own home and/or refer when necessary and safe to do so. Moreover, there is minimal knowledge on dermatology in the paramedic profession, further fortifying the importance of learning about the best treatment option for psoriasis. A stepwise approach to treatment is recommended, dependent on the severity of the disease (National Institute for Health and Care Excellence, 2012).

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