Question

When assessing a dark-skinned client with psoriasis, which finding would be consistent with the SES of the disorder? a. Raised, sharply-demarcated plaques that appear purple in color b. Silvery scales on an indurated, erythematous base c. Translucent, pearly appearing pink to red papules d. Honey-colored crusts on shallow ulcers

Short answer

a. Raised, sharply-demarcated plaques that appear purple in color

Step-by-step solution

Understand the Question

Identify what is being asked. The question pertains to findings consistent with psoriasis in a dark-skinned client.

Analyze Each Option

Evaluate each of the given options to determine which one matches the characteristics of psoriasis.

Option A: Raised, sharply-demarcated plaques that appear purple in color

Examine this option. Raised plaques with sharp borders that appear purple are a characteristic feature often found in psoriasis, especially in dark-skinned individuals.

Option B: Silvery scales on an indurated, erythematous base

Consider this option. Silvery scales on a red, thickened base are classic signs of psoriasis, but in dark-skinned individuals, the erythematous base may appear more purple than red.

Option C: Translucent, pearly appearing pink to red papules

Evaluate this option. This description is more indicative of basal cell carcinoma rather than psoriasis.

Option D: Honey-colored crusts on shallow ulcers

Review this option. This description typically relates to impetigo, not psoriasis.

Determine the Correct Answer

Considering the evidence, option A best describes a finding consistent with psoriasis in a dark-skinned client.

Key concepts

Psoriasis characteristics

Psoriasis is a chronic, immune-mediated skin condition that presents differently based on the individual's skin tone. Psoriasis is often identified by its hallmark characteristics: thick, raised plaques covered in silvery scales. For dark-skinned individuals, these plaques can appear purple or dark brown rather than the traditional erythematous (red) appearance seen in lighter skin tones.
This variation can sometimes lead to underdiagnosis or misdiagnosis, making it crucial for healthcare professionals to familiarize themselves with how psoriasis presents across different skin types.
Common symptoms include:

• Itching or burning sensations on the affected areas
• Dry or cracked skin that may bleed
• Thickened and ridged nails
• Joint pain in cases of psoriatic arthritis

Accurate identification is essential for effective management and treatment of psoriasis, aiming to minimize symptoms and improve the patient's quality of life.

Skin assessment

Proper skin assessment is a critical skill for nurses and healthcare providers, especially when diagnosing conditions like psoriasis in dark-skinned individuals. Performing a thorough skin assessment involves several key steps:

• Inspecting the skin visually under good lighting
• Noting the distribution, color, and type of lesions or rashes
• Assessing the thickness and texture of the affected areas
• Examining the patient's nails and scalp for related symptoms

Understanding the subtleties in skin presentation is crucial. For instance, in dark-skinned patients, erythema may not present as bright red but rather purplish or darkened patches.
Additionally, utilizing dermoscopy can help in visualizing psoriasis features that are not easily noticeable with the naked eye. This tool enhances the diagnostic accuracy and ensures patients receive appropriate and timely treatment.

Dermatology for nurses

Dermatology encompasses a wide array of skin conditions, with psoriasis being one of the more common chronic disorders that nurses will encounter. Nurses play a pivotal role in the early detection and ongoing management of psoriasis, especially in diverse populations.
Key competencies in dermatology for nurses include:

• Recognizing various skin conditions and differentiating between similar presentations
• Performing comprehensive skin assessments
• Educating patients on skin care and management strategies
• Administering and monitoring treatments, such as topical medications, phototherapy, and systemic agents
• Supporting patients through the psychosocial impacts of visible skin conditions

Staying updated with dermatological knowledge, especially concerning how conditions like psoriasis manifest across different skin tones, enhances nurses' capacity to provide patient-centered care.
Comprehensive education and continual learning empower nurses to advocate effectively for their patients and contribute to improved health outcomes.