Psoriasis is a common, chronic, inflammatory, and proliferative condition of the skin, associated with systemic manifestations in many organ systems. According to Dr Dhanya Rajkumar, psoriasis is a noncommunicable, disfiguring and disabling disease that significantly negatively impacts the quality of life for those with the disease.
The most common characteristic of the skin rash is red, scaly, sharply demarcated lesions that are seen particularly over the extensor surfaces and scalp. Psoriasis can also affect the nails and joints. According to the International Association of Psoriasis Federations, approximately 125 million individuals across the globe are affected by psoriasis.
According to Dr Rajkumar, a specialist dermatologist at Medcare Hospital Sharjah, special consideration should be given to lifestyle factors and behaviours that contribute to the overall health and treatment responsiveness. These include weight management and quitting smoking. In addition, the use of thick, non-fragranced moisturisers daily is recommended in conjunction with additional baths, which can be infused with colloidal oatmeal, Epsom salts or coal tar to help alleviate inflammation, irritation, dryness, and redness.
For reasons yet to be known, the use of UV light is said to improve the remission of psoriasis lesions. Thus, while most individuals avoid sunbathing to decrease the risk of developing skin cancer, those who have psoriasis may benefit from it.
There is no known cause of psoriasis; however, there are several lifestyle factors to consider to reduce its appearance and spread.
“It is suggested that excessive alcohol consumption is associated with moderate to severe psoriasis and should therefore be avoided,” Dr Rajkumar explains. “Smoking also causes an increased risk of developing psoriasis.”
Also, any infection that affects the immune system can trigger a certain type of psoriasis, which is why there can often be a flare-up following an ear infection, bronchitis, tonsillitis, or even respiratory infection.
Dr Rajkumar also explains that increased levels of depression, anxiety and worry often results in flare-ups of the disease, leading to moderate or sometimes even severe psoriasis. Even though sunlight is suggested to be beneficial to individuals with psoriasis, in some cases, psoriasis may be provoked by sunlight, so if a person experiences an aggravated case of psoriasis following sun exposure, future minimised exposure is advised.
Treatment for psoriasis
There are various treatment modalities for psoriasis, depending on the type and severity of the disease. According to Dr Rajkumar, mild plaque psoriasis without psoriatic arthritis can be treated with various topical treatments such as coal tar, potent topical corticosteroids, vitamin D analogues, followed by phototherapy as a second line of treatment.
In moderate to severe plaque psoriasis treatment, phototherapy is the first line of treatment, followed by oral medications such as immunosuppressants and apremilast.
“In case patients do not respond to the above treatment, the next step is biologicals, which can have a great promise for individuals with moderate to severe psoriasis, and they represent a significant step forward in the development of psoriasis medications that will improve the quality of life of patients,” Dr Rajkumar concludes.
“Biologics are systemic drugs that target only specific parts of the immune system. Biologics used in psoriasis target cells and proteins that cause inflammation, the rapid growth of skin cells, and damage to the joint tissue, e.g., TNF alpha, interleukins 12, 17,23. Therefore, biologics selectively targets these proteins, thereby reducing the psoriatic symptoms.”
