Grappling with a medical condition is challenging enough. However, dealing with one where symptoms are obvious can be overwhelming. For those with skin ailments, this is part of daily life.
The disease like Psoriasis is a chronic long-standing immune-related disease that not only affects the skin, but also the scalp, nails and joints.
In Malaysia, it is estimated that approximately two to three per cent of the population is affected by Psoriasis, which is a non-contagious disease.
Sunway Medical Centre consultant dermatologist Dr Felix Yap Boon Bin says in psoriasis, immune dysregulation causes inflammation in the second layer of the skin (dermis) and increases production of cells in the upper layer (epidermis).
This leads to the formation of thick red patches with white silvery scales on the skin surface. These lesions may sometimes present with itchiness and irritation.
Those with a family history of Psoriasis are more likely to have it. Usually Psoriasis located on the elbows, kneecaps, scalp, navel, buttocks, lower back and legs.
Dr Yap says, there is a genetic link to psoriasis. This is because various genes have been identified to play a role in the disease over the years.
STILL UNAWARE
Unfortunately, awareness is still lacking. Usually many patients do not know they have the disease until the condition becomes worse.
Besides the red thick lesions, nail changes are also common. Usually, most patients are misdiagnosed as having eczema or skin allergies, but later they will be diagnosed with psoriasis by a dermatologist.
Dr Yap says, psoriasis patients is not advisable for oral or injected steroids because it may worsen their condition. So proper diagnosis from the very beginning is crucial to prevent disease progression.
Joint pain is also a symptom psoriasis. However, those suffering from it will think they have gout or rheumatism. Similarly, nail disease in psoriasis patients will think they have or confused with fungal infection.
Many patients are then treated for fungal infection until they see a dermatologist and discover that they have nail psoriasis.
“Long-term psoriasis may also lead to obesity, hypertension, diabetes and eventual cardiovascular conditions, such as heart attack and stroke,” adds Dr Yap.
Worsening of skin lesions, for example, a small patch growing to a bigger one, or developing more skin patches on the body and new onset of nail changes and joint pain, indicates disease progression.
The disease can worsen to affect the whole body. Once this occurs, patients may become susceptible to bacterial infection in the skin.
Worsening of disease among psoriasis patients is usually caused by delay in seeking treatment or severe dysregulation of the immune system caused by stress, illness or medication.
BALANCED APPROACH
Proper lifestyle changes, such as exercising and eating a balanced diet with proper treatment by a dermatologist can help control the condition.
Dr Yap says the pandemic has changed the landscape of psoriasis care and management. The pandemic cause many patients have been unable to see their doctors, and this has led to a worsening of their condition.
Stress caused by loss of work and lockdowns has further deteriorated the patients’ wellbeing.
Medications that suppress the immune system, which are commonly used to treat psoriasis, are also being used less in the Covid-19 era as doctors fear that a weakened immune system may be detrimental if their patients contract Covid-19.
Dr Yap explains, medications that do not cause immune suppression would be favoured. Biologic treatment is ideal as it does not alter or weaken the whole immune system.
Those with psoriasis are not at an increased risk of getting Covid-19 and will not suffer a more severe form of the coronavirus disease compared with normal individuals, unless they are on immunosuppressive medication.
Dr Yap says it is advisable for all psoriasis patients to get Covid-19 vaccination. However, those on immunosuppressive medication need to stop taking their medicine on the week of the injection. Biologic treatment is not altered in any way by Covid-19 vaccination.
Source: Meera Murugesan (NST.COM.MY)
