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Chief Complaint

“My hands are stiff and sore”

History of Present Illness

Kathy Bennet is a 52-year-old female who presents to her primary care provider today for a 12-week follow-up appointment. KB is complaining of pain and stiffness in her hands. KB states that she has been taking ibuprofen “around the clock” to help control her pain. KB states that she has been experiencing this pain for approximately 3 weeks but did not seek help at the time.

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Missing Information?


Patient Database

Drug Therapy Problems

Care Plan (by Problem)


  1. What comorbidities are associated with psoriasis?

    Hint: See Treatment of Acute Gout Flare in PPP

  2. What are the general characteristics, signs and symptoms of plaque psoriasis?

    Hint: See Treatment of Acute Gout Flare and Urate-Lowering Therapy for Gout Prophylaxis in PPP

  3. What are the goals of therapy for psoriatic arthritis (PsA)?

    Hint: See Urate-Lowering Therapy for Gout Prophylaxis in PPP

  4. What factors may be contributing to the increased severity of the patient’s plaque psoriasis and the onset of psoriatic arthritis?

    Hint: See Urate-Lowering Therapy for Gout Prophylaxis in PPP

  5. What factors must be taken into consideration in identifying the right therapy for a patient with psoriasis?

    Hint: See Urate-Lowering Therapy for Gout Prophylaxis in PPP


The patient returns to the office 4 weeks later for a follow-up appointment. The patient reports significant improvement in his pain and stiffness (4/10 on pain scale). Their lesions have improved dramatically.

6. What actions will you take, if any, to enhance the therapeutic effect of the patient’s current therapy?

7. What additional steps will you take to ensure that the patient enters remission and experiences minimal flare-ups for his psoriasis?


Global Perspective

Psoriasis is a common chronic inflammatory disease of the skin that is seen in people throughout the world. Incidence and prevalence of psoriasis continues to be studied on an ongoing basis. It is thought that psoriasis dates back to Biblical times as a similar disorder is made mention of in the Bible. Throughout the years, the diagnosis of psoriasis has changed as more has been understood about the disease. Several patterns have been identified in studies that have been conducted in patients suffering from psoriasis. However, these findings cannot always be deemed conclusive for the fact that many patients do not seek medication attention for the treatment of psoriasis. Observations include a greater incidence of psoriasis seen in patients living in regions further from the equator. Studies conducted in Australia show that people residing ...

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