Addressing Misconceptions and Supporting Patients in Psoriasis

29 October 2024

Psoriasis is a chronic, immune-mediated skin condition affecting nearly 2 to 3 per cent of the world’s population, and over 60 million people worldwide, according to the Global Psoriasis Atlas.

Often misunderstood and mistaken for other skin diseases, it goes beyond mere cosmetic concerns, impacting both physical and mental health partly due to its various complications including arthritis, hypertension, diabetes mellitus, heart disease, and depression.

Dr Sharifah Rosniza Syed Nong Chek, consultant dermatologist at Sunway Medical Centre, sheds light on the complexities of psoriasis, its impact on patients, and the importance of early diagnosis and continuous treatment.

“Psoriasis is not just a skin disease; it is an immune-mediated condition where certain cells in the immune system trigger the skin to produce new cells at an accelerated rate,” explained Dr Sharifah.

“Normally, skin cells regenerate every 30 days, but in psoriasis, this cycle can be as fast as three to five days, causing excessive new skin cells to build up into thick, scaly plaques,” she added.

Common Symptoms And Types Of Psoriasis

In Malaysia, the most prevalent form of psoriasis is plaque psoriasis, accounting for over 80 per cent of cases.

“Patients typically present themselves with red rashes that often have thick and silvery scales. These rashes commonly affect areas like the scalp, elbows, knees, and lower back,” Dr Sharifah noted.

Other types include guttate psoriasis, which often follows a throat infection and presents as small, dot-like lesions; pustular psoriasis, which features pus-filled blisters; and inverse psoriasis, occurring in skin folds and often mistaken for a fungal infection due to its location and appearance.

Profound Impact Of Psoriasis On Patients’ Physical And Mental Health

The visibility of psoriasis lesions often leads to social stigma and emotional distress.

“The appearance of the rash can be quite embarrassing, especially in visible areas like the scalp and face.

The patient might also complain of itchiness, sometimes severe enough to disrupt sleep, and skin can be painful due to cracks forming on the thick rash,” said Dr Sharifah.

Beyond physical discomfort, psoriasis patients frequently face psychological challenges.

“Many patients suffer from low self-esteem, anxiety, and depression,” Dr Sharifah added.

Misconceptions And Stigma Of Psoriasis

One of the most pervasive misconceptions about psoriasis is that it is contagious.

“This is absolutely false; psoriasis is not infectious, but it is an autoimmune disease. Skin diseases like psoriasis are wrongly associated with poor hygiene due to their physical appearance, leading to discrimination and social isolation.

“Unfortunately, the lack of public awareness leads to patients feeling isolated and misunderstood,” added Dr Sharifah.

Another misconception is that psoriasis is curable.

“There is no cure for psoriasis, but the symptoms and flare-ups can be managed effectively. These treatments aim to control the symptoms and manage flare-ups, but the condition can go into remission where the skin appears normal.

“This state is not a cure but a temporary reprieve. It’s important to note this because some patients may not realise it, making them vulnerable to alternative treatments or unscrupulous individuals that offerr false hope of a cure,” she emphasised.

Preventing Complications With Early, Consistent Treatment

Early diagnosis and consistent treatment are crucial in managing psoriasis and preventing complications.

One of the most concerning progressions is psoriatic arthritis, a chronic
inflammatory disease affecting up to 30 per cent of psoriasis patients.

“If left untreated, psoriasis can lead to severe complications, including psoriatic arthritis, which can cause joint damage and disability,” warned Dr Sharifah.

Furthermore, psoriasis is also associated with obesity, and can lead to metabolic syndrome such as hypertension, diabetes mellitus, and high cholesterol.

“This is why monitoring and early intervention can significantly reduce the risk of these serious health problems from developing,” shared Dr Sharifah.

Psoriasis treatment varies depending on the severity and type of psoriasis. Topical treatments, including steroids, salicylic acid ointment, Vitamin D analogues, and tar-based preparations are usually the first line of treatment.

“For more severe cases, phototherapy, oral medications, and biologic medications are available.

“Several new treatments including biologics, which target specific parts of the immune system, have shown promising results in managing psoriasis effectively,” Dr Sharifah explained.

Raising Awareness, Empathy, And Family Support For Psoriasis

Education about psoriasis and family support is vital to help combat stigma and misinformation.

“We need to create a supportive environment where psoriasis patients feel
understood and receive appropriate lifelong care.

“Support groups and associations provide crucial support for both patients and their families.

“Health care professionals also play a key role in offering education and support to patients and their loved ones, especially in learning about the disease, identifying and preventing the triggers that can cause flare ups and dispelling the many misconceptions on the disease,” according to Dr Sharifah.

Living with psoriasis remains a challenging condition, but increased awareness, early diagnosis, and consistent treatment can significantly improve the quality of life for those affected.

“Psoriasis is a lifelong condition, but with proper management, you can lead a fulfilling life. Be mindful of the symptoms and seek help early and regularly from a dermatologist.

“Adhere to your treatment plan and don’t hesitate to reach out for support. Families should also educate themselves about the disease and find ways to best support their loved ones on this journey,” said Dr Sharifah.

Source: OVA

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