Patient Care Plan for the Management of Psoriasis. Patient Name: Hospital Number: Date of Birth: Date of care plan: Consultant: Date of last plan:

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1 Patient Information Patient Name: Patient Care Plan for the Management of Psoriasis Hospital Number: Date of Birth: Date of care plan: Consultant: Date of last plan: Care Plan The purpose of this document is to give you helpful information and advice, providing an individual based care plan to help manage your skin condition (psoriasis). Helping to create and develop strategies to keep the condition of your skin at an optimum. Psoriasis Psoriasis is a chronic condition that affects about 2% of the population at any one time with equal amount of men and women affected. For people with psoriasis, skin replacement speeds up, taking only a few days to replace skin cells rather than days. Due to this, plaques are created where the skin builds up. Psoriasis can affect any part of the body; can occur at any age, there can be a family history but not always. Psoriasis can be triggered by stress, anxiety, hormonal changes, injury to skin, certain infections and medications. PIL08965/Apr13reviewApr15 N.Cole This leaflet is available in other languages, large print, braille or audio formats. Medical Photography: patient.information@tst.nhs.uk Musgrove Park Hospital is part of Taunton and Somerset NHS Foundation Trust

2 General Information & Advice Bathing/showering & soap substitutes Use tepid temperature water, making sure it is not too hot, bathing for no longer than 10 minutes. Use bath oils rather than bath bubbles and an emollient to wash with rather than soap. These products will help moisturise your skin rather than drying it out, which is what soap products will do. Apply the emollient to skin prior to get in the bath or shower and then use the water to wash it off. Apply an emollient to skin straight after bathing while the skin is still slightly damp, to help lock in the moisture. Making sure you pat dry rather than rubbing. Moisturising and emollients Emollients are often called moisturisers. They are lotions, creams, ointments and bath/shower additives which oil the skin to keep it supple and moist. Regular use of emollients is the most important part of the day-to-day treatment for people with dry skin conditions. People with psoriasis often have dry skin which becomes itchy and irritated. By scratching these areas, new psoriasis plaques can develop. Through applying emollients to dry skin, this helps prevent this from happening. Emollients are bland products with no active ingredients, so there is no limit to amount of times a day it can be applied to the skin. You can change the emollient if it does not suit your skin. Emollients should be applied in the direction of the hair growth, if it is applied against, this can cause infection of the hair follicle. Topical Steroids Use as prescribed but normally twice a day, once in the morning and once in the evening. The topical steroid comes as a cream or ointment, depending on what your consultant prescribes. Steroid reduces inflammation and speeds up healing of the skin. Use fingertip guide for application of topical steroid. Emollient and topical steroid Topical steroids are very different to emollients, and should be used and applied in a different way. When using the two treatments, apply at separate times. Wait minutes between applications of the emollient and topical steroid. That is, the emollient should be allowed to absorb before a topical steroid is applied or vice versa.

3 Action Plan: Psoriasis under control When skin is plaque free Emollient: Apply times a day Soap substitute: Moisturise whole body with the above emollient cream. Action Plan: Mild plaque formation When you are starting to notice plaques form Continue to apply emollient to skin Consider applying a greasy ointment at night Watch for and use prescribed topical corticosteroid ointment on red/plaque areas APPLY MOISTURISER FIRST Emollient: day Night: Bath oil or soap substitute: Other prescribed medication: WAIT MINUTES BEFORE APPLYING CORTICOSTEROID CREAM/OINTMENT Face: Scalp: Body: Action Plan: Moderate to severe psoriasis flare When psoriasis is not responding to previous action plan Use corticosteroid ointment prescribed by your doctor Corticosteroid ointment: Face: Scalp: Body: Emollient: day Night: Bath oil or soap substitute: Other prescribed medication: Completed by: Signed: Date:

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