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Living with Psoriasis


By Webmaster | Malaysia | Thu Dec 20, 2018 7:35pm

Psoriasis is a non-contagious chronic inflammatory skin disease characterized by rapid growth of the outer skin layer, resulting in thick, silvery flakes of scale on raised pinkish red skin with well-defined margins. It is an auto-immune disorder that cannot be cured but can be controlled.


Not many people really know about psoriasis. What are the symptoms of psoriasis?

Patients with plaque psoriasis suffer from the patches of raised, red scaly skin caused by excessive skin production1. These lesions are called plaques. It is usually found on the elbows, knees, lower back and scalp, but it can occur anywhere on the body1. When you have the symptom, it is advisable to visit your doctor and obtain a proper diagnosis.


How many people suffer from body psoriasis?

Psoriasis is a common auto-immune disease affecting the skin. It is thought that 1-3% of the world’s population is affected by psoriasis, which is around one in fifty people1.


How does psoriasis affect peoples’ lives?

 

Psoriasis has a debilitating effect on the quality of life of patients. Patients often suffer from feelings of isolation, low self-esteem and depression2. There is no cure, but the condition can be controlled with an appropriate treatment.

 

How can I prevent psoriasis?

Psoriasis being an auto-immune condition is a non-preventable disease.


What is the cause of psoriasis?

Studies suggest that genes play an important part in making one prone to the development of psoriasis, although environmental factors may be necessary to trigger the appearance of psoriasis. The immune system, once activated, triggers the rapid growth of skin cells, which reach the surface in 3-5 days instead of the usual 28-30 days resulting in an accumulation of excessive skin cells on the surface1.


How bad can psoriasis get?

Psoriasis can be limited to a few areas of the skin (mild), or it can be moderate or widespread and severe. A normal skin cell matures in 28-30 days and sheds from the skin unnoticed1. Psoriatic skin cells mature in only 3-5 days. They “heap up” and form scaly lesions. Psoriasis lesions can be painful and itchy and they can crack and bleed. Plaques on the hands and feet can prevent individuals from working at certain occupations, taking part in some sporting activities and even caring for their family1.

 
Debilitating impact on patient’s quality of life

Psoriasis can have a debilitating impact on an individual’s self-image, self-esteem and sense of wellbeing2. These negative impacts can be similar or greater than that created by life threatening illnesses like cancer, arthritis, hypertension, heart disease, diabetes and depression3. People with psoriasis can feel stigmatized by members of the public who mistakenly believe it is contagious, to the extent that individuals report being asked to leave public swimming pools, gyms and hairdressers. This can make psoriasis patients feel ostracized, leading to feelings of isolation and depression2. Itching and pain can interfere with basic everyday functions, such as washing, dressing, sleeping.


Treatment Options

There is no cure for psoriasis, but the condition can be effectively managed with a range of treatments. Topical agents are usually used as first line treatment for psoriasis.

  • Topical therapies – include creams, ointments, gels and lotions applied to the skin – are considered to be suitable for 70 to 80% of patients with mild to moderate psoriasis1. Commonly used topical therapies include both Vitamin D analogue and a steroid, thereby optimizing the effect. Vitamin D analogues normalizes the “sick” skin cells in a way that reduces the fast turn-over rate and prevents the formation of new plaques. The steroids work primarily by reducing inflammation. Additional topical therapies include coal tar and calcineurin inhibitors. Emollients are used as a general treatment in non-acute phases of psoriasis. Regular use of an emollient can alleviate pruritus, reduce scale and enhance penetration of concomitant topical treatment.
  • Phototherapy – phototherapy or light therapy, involves exposing the skin to ultraviolet light on a regular basis and under medical supervision.
  • Systemic medications – systemic medications are prescription drugs that work throughout the body. They are usually used for individuals with moderate to severe psoriasis and psoriatic arthritis. Systemic medications are also used in those who are not responsive or are unable to take topical medications or UV light therapy. Patients with severe disease are often given systemic therapies and photo therapy, frequently in combination with topical therapies.
  • Biologic drugs – Biologic drugs, or “biologics,” are a relatively new class of treatment for psoriasis and psoriatic arthritis. They are administered by injection or intravenous (IV) infusion.


References

  1. Schon MP et al. Psoriasis. N Engl J Med 2005; 352(18): p.1899-912
  2. Kimball AB et al. The psychosocial burden of psoriasis. AM J Clin Dermatol 2005; 6(6): p.383-92.
  3. Rapp SR et al. Psoriasis causes much disability as other major medical diseases. J AM Acad Dermatol 1999; 41(3): p.401-7.

 

 

 






 

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