Do you know what this skin condition is?
It is known as psoriasis.
Psoriasis is a non-contagious, long-term autoimmune condition where the skin grows much faster than normal skin, resulting in the shedding of scales of skin. What happened is that the immune system attacks healthy skin cells by mistake, resulting in an increased production of the cells. The new skin cells move to the outermost layer of the skin and form thick, scaly patches.
The areas that are most commonly affected are the scalp, elbows and knees, forearm and shin but it can occur anywhere on the body including nails. In those areas, red scaly patches will be observed. People with psoriasis may experience pain and itchiness in those areas.
It is worth noting that psoriasis is not merely a skin condition but a systemic inflammation that can affect other parts of the body.
How serious is psoriasis?
Psoriasis is a chronic skin disease affecting nearly 2% of the world population. In Malaysia, a total of 12,615 patients with psoriasis have been reported during the period from October 2007 to December 2014.
Psoriasis requires lifelong treatment, and, even with the best of care, can suddenly flare up, thus causing significant physical, emotional and social burdens to the patients. Serious psoriasis if left untreated can even lead to death. Severe psoriasis that covers more than 90% of the skin can lead to sepsis, i.e. bacterial infection in the blood. Sepsis can rapidly cause tissue damage, organ failure and death.
Psoriasis cannot be cured, but its symptoms can be managed better over time, hence maintaining the highest possible quality of life.
Minimising triggers that can cause psoriatic flare up
There are a myriad of reasons that can cause trigger flare up in psoriasis. Here we lay the more common triggers for psoriasis and ways to manage them:
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Infections, such as strep throat or skin infections -- To reduce the likelihood to get skin infections, psoriasis patients can wash their body with antibacterial soap and change clothes regularly. Most importantly, psoriasis patients are advised to seek healthcare professional help if there are any skin infections and/or acne issues.
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Skin injuries from cuts, scrapes, insect bites, bruises, sunburn or even friction against tight clothing. Skin injuries can cause psoriasis to flare along the line of the trauma, a phenomenon known as the Koebner phenomenon. -- To manage skin injuries, apply ice application or compression bandage immediately, then see a doctor thereafter. Psoriasis patients should also adopt the habits of applying sunscreen when going out, limit sun exposure whenever there is a flare up and moisturize skin regularly to reduce itchiness and strengthen skin barriers. If the itching is unbearable, they are advised to see a pharmacist or doctor to purchase topical corticosteroid cream.
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Smoking or exposure to second-hand smoke can worsen psoriasis -- Individuals with psoriasis should refrain from smoking or exposing themselves to second-hand smoke. If they also happened to be smokers, see a pharmacist or doctor for smoking cessation therapies. Nicotine-replacement therapy can be started to help them quit smoking.
Managing emotional stress associated with psoriasis
Embarrassment, shame and anger are just a few of the negative emotions experienced by psoriasis patients frequently. This is true especially for Malaysia’s society as the public do not have high awareness about psoriasis. Some of which even think psoriasis is contagious, which may result in discrimation against psoriasis patients. As such, they often experience isolation, stress, over self-consciousness and anxiety. Psoriasis certainly also affects their ability to socialise and disrupts intimate relationships with their partner. They also have to deal with the uncertainty of having flare up everyday, thus impacting their participation in normal daily routines. As such, these emotional impacts can develop into mental health conditions, which in turn also acts as the trigger for flare up in psoriasis.
To overcome emotional stress, individuals with psoriasis are encouraged to find strategies to manage stress and deal with the occasional fluctuations that characterise the disease. They can try mind-body therapies, which involve focusing on immediate sensations—the here and now—rather than projecting into the future or fixating on anxieties or insecurities. They include meditation, yoga, Tai Chi, deep-breathing exercise and many more.
However, if those measures do not provide any comfort, consider seeing a therapist or psychiatrist might help. You can find more information about getting professional mental help services here.
Managing comorbidities associated with psoriasis
People with psoriasis are also at a higher risk for certain diseases, such as arthritis, high blood pressure, heart disease, mental health conditions and diabetes. These related conditions are known as co-morbidities. In Malaysia, as many as 23.6% of psoriasis patients are obese, 26.3 % have hypertension and 17.4% have diabetes.
Hence, psoriasis patients are encouraged to attend follow-up and regular screening with their doctors.
