Psoriasis A Treatable disease

Psoriasis is a common chronic auto inflammatory skin disease of unknown origin that manifests in a genetically predisposed individual. It is characterized by appearance of slightly itchy multiple scaly red patches on the body, trunk, dorsal aspects of arms, forearms, thighs and legs. Scalp, nails, palms and soles are also affected. Approximately 2-4% of the population are affected through out the world. In India, the prevalence rates are 0.5-1.5%.  It is seen in all age groups in both sexes. Relapses and remissions are common. The disease has a significant impact on quality of life.

Facts about Psoriasis:  

• Psoriasis is neither infectious nor communicable disease.
• It is not a life-threatening disease.
• One can marry and have normal family life.
• Psoriatic patients can become pregnant have normal children.
• The exact cause of this disease is not known.
• Heredity seems to play a role. The exact mode of inheritance is not established.
• About 30% of patients have an affected first – degree relative.
• If only one parent is affected, the risk for child is 16%.
• If both parents are affected, the risk increases to 50%.
• Physical and mental stress, viral and bacterial infections, environmental factors (winter, sunlight), drugs (Homeopathy, Ayurveda and some allopathic drugs), Alcohol, smoking may aggravate or precipitate psoriasis in a genetically predisposed individual.
• It is a chronic disease like diabetes and manageable disease.

Is Psoriasis beyond the skin disease?

• Of late, Psoriasis is considered to be a systemic disease because of its association with several illnesses (comorbidities) like
• Psoriatic arthritis – nearly 7-30% of patients develop arthritis of smaller joints of hands and feet.
• Metabolic syndromes – hypertension, dyslipidemias, obesity, higher cardio vascular disease risk.
• Psycho social burden - depression, suicidal tendencies and alcoholism.
• Pulmonary obstructive disease
• Crohn’s disease and ulcerative colitis.
• Ocular inflammation.

Patients with moderate to severe psoriatic skin disease have a higher association with these comorbidities, which may be related through common pathogenic mechanism.

Psoriasis and Longevity: Due to the above comorbidities, psoriatic patients may have decreased longevity.  There is 3–4-year reduction in life expectancy in patients of severe psoriasis.  

Psoriasis and Cancer:  The cancer risk is elevated in severe psoriatic cases. Psoriasis patients over 65 years have a threefold increase in both skin and systemic cancers.

Management of Psoriasis: Though there is no permanent cure for psoriasis, but the disease can be manageable and controlled, like any other chronic diseases (diabetes, thyroid disease, asthma etc.). With the advent of newer biological therapies, various immunomodulators, phototherapies and topicals the disease can be treatable. Lifestyle modification methods like yoga, meditation, exercise, low calory diets, no alcohol and no smoking would certainly play a supportive role in the management of Psoriasis.

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