Give Them a Hand: Patients With Hand and Foot Psoriasis Require Special Attention

Linda Daus, RN, CCRC


Dermatology Nursing. 2008;20(4):291-293. 

In This Article

Role of the Dermatology Nurse in Managing Hand and Foot Psoriasis

The dermatology nurse's primary goal with all patients is to improve their quality of life, and this is especially important for patients with hand and foot psoriasis. As nurses, we have responsibility for helping these patients become functional again in their jobs, with families, and in relationships. Meeting these patients' physical, psychological, and emotional needs is a key priority. Patient screening is one important method that dermatology nurses must use in an effort to determine these needs. A sound approach here is designing a quality of life questionnaire that assesses the patient's recent, overall well-being by asking such questions as:

  • How itchy, sore, painful, or stinging has your skin been?

  • How embarrassed or self-conscious have you been because of your skin?

  • How much has your skin interfered with you going shopping, or looking after your home or garden?

  • Has your skin prevented you from working or studying?

Patient counseling, support, and education are important to achieving therapeutic success. Educating patients about their disease and the prescribed treatment is paramount. For example, dermatology nurses who give patients injection training for biologic agents should also emphasize to them the importance of compliance with that particular therapy. Compassion is also key.

When only a small area of the body is covered, patients with hand and foot psoriasis encounter difficulties in convincing others, such as family members, co-workers, employers, and even insurers, of the negative impact this condition may have on their quality of life. As such, it is sometimes necessary for the dermatology nurse to step in and serve as the patient's advocate when interacting with employers or insurance companies. Nurses may on occasion need to inform an employer that until the patient's psoriasis begins to show improvement, his or her ability to perform the job in question may be limited.

Some health insurers mandate 10% or more body coverage ("severe" according to guidelines) before reimbursing biological treatment for psoriasis. Hand and foot psoriasis may cover less than 2% of the body even though it can be more devastating than generalized psoriasis.


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