According to Global Psoriasis Atlas, an estimated 3.59 million people in India are living with psoriasis, an autoimmune and inflammatory condition in which T lymphocytes (a type of white blood cell) abnormally trigger inflammation in the skin as well as other parts of the body. This causes skin cells to develop rapidly before the body can shed the old skin, resulting in visible signs of inflammation like raised, dry, itchy and flaky red patches or silvery scales on the skin. Psoriasis flare-ups usually appear on the skin of hands, feet, neck, scalp, face and skin folds. In rare cases, psoriasis can also affect the nails and genital area.
Although the exact cause of psoriasis remains unclear, genetic and environmental factors play a substantial role in triggering the symptoms of psoriasis. Based on several studies, some of the triggers that have been identified are stress, smoking, drinking alcohol, skin injury, etc. Triggers can be unique to individual patients.
Delay in diagnosis has negative implications
It has been observed that people with psoriasis tend to ignore their initial symptoms and often neglect and overlook psoriasis flare-ups to be ordinary skin rashes. They often self-medicate through home remedies for achieving immediate relief but this may worsen the condition even more. The absence of treatment due to delay in diagnosis can also lead to severe co-morbidities such as psoriatic arthritis, cardiovascular diseases, diabetes and depression. Psoriatic arthritis is one of the key co-morbidities of psoriasis. Approximately one in every four people with psoriasis is living with psoriatic arthritis. Therefore, early recognition and diagnosis is the key to achieving long-term remissions and subsequently decreases the risk of developing co-morbidities. Along with timely diagnosis and treatment, continuous monitoring of symptoms by your dermatologist is essential to detect early signs of these associated diseases.
Although there is no absolute cure available for treating psoriasis permanently, it can be effectively managed by adhering to prescribed medication by the dermatologist. Appropriate treatment is prescribed upon examining the severity of the affected area. A patient living with mild psoriasis can be prescribed topical treatments. However, for people with moderate to severe psoriasis, treatment with advanced therapies like immunosuppressants and biologics may help in achieving long-term remission and reduce disease progression.
Creating awareness about psoriasis and its causes and symptoms can play a pivotal role in decreasing the psychological burden associated with this condition. Hence, an informed patient will be in a better position to manage this condition effectively.
New challenges in management of psoriasis due to COVID-19 pandemic
In the backdrop of the pandemic, panic and uncertainty have sometimes led to poor adherence to treatment among people with psoriasis. It has also been observed that some patients discontinued their medication amid the fear of contracting the coronavirus, especially people on immunosuppressive therapies like biologics. Limited access to the dermatologist and lack of proper treatment caused stress and anxiety among patients, impacting their mental health. Recent research has shown that discontinuation of treatment can worsen a psoriasis patient’s condition.
During the ongoing pandemic, patients should not alter any aspect of their treatment without consulting their dermatologist. It is advisable for patients to consult their doctor regarding the continuation of their ongoing biological treatment, who may decide on whether there is a need to prescribe alternate medication depending upon various clinical factors. Elderly patients and those with co-morbidities, such as cardiovascular diseases, diabetes, etc. are more susceptible to develop advanced symptoms and may need closer monitoring and extra care. While it’s a good idea to adopt virtual channels for a routine consultation, visiting the clinic (with all the necessary precautions in place) when needed must not be avoided.
Psoriasis doesn’t spread through physical contact. Yet, due to the prevalent myths of psoriasis being contagious, patients are often subjected to alienation and humiliation. Building a conducive environment is essential to facilitate psychological comfort for the patients and minimize the stigma associated with psoriasis in society.
This article was written by Dr Monica Bambroo, Head of Dermatology & Cosmetology, Artemis Hospitals, Gurugram.
For more information, read our article on Psoriasis.
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