a Psoriasis is a chronic, inflammatory, autoimmune and systemic disease estimated to affect 125 million people worldwide, of whom about 14 million are in Europe. In Portugal, data from the Portuguese Psoriasis Society (PSO Portugal) show that the disease affects more than 200,000 people. However, theory now shows that the number could be much higher.
In an interview with lifestyle by the minuteDr. Louise Light, a dermatologist at the Clinic Laser de Belém in Lisbon, believes there are “definitely” more undiagnosed cases in the country. The doctor also warns of higher rates of depression, anxiety, low self-esteem, and effects even on intimacy.
How many cases of psoriasis have been diagnosed in Portugal?
There are statistics that the incidence of psoriasis can reach 6%, which is three times more than the 2% that we know, corresponding to 200 thousand patients with pathology. However, there are those who do not seek medical help, so we cannot obtain specific data.
There are subclinical forms of psoriasis where people have mild lesions so they don’t know they have psoriasis or localized forms of psoriasis that are classified as other diseases. Forms of psoriasis are found only in the nails, which leads people to interpret that they are infected with fungi, and therefore treat them with antifungal agents, and among other things, forms of genital psoriasis, which are often confused with candidiasis. Thus, the 2% that we are aware of does not correspond to reality. It is superior. There are certainly more than 200,000 patients with psoriasis in Portugal.
Psoriasis usually occurs in young people, which does not mean that it cannot appear in old age
Is the incidence of psoriasis different between men and women?
Psoriasis affects both men and women. However, there are forms of psoriasis that appear in childhood and adolescence. Psoriasis usually occurs in young people, which does not mean that it cannot appear in old age. There are cases of people in their thirties seeking medical attention because they have symptoms and this is normal. On the other hand, there are still cases in grandchildren appearing before the rest of the family. There is a genetic predisposition, but it is not always visible.
What causes psoriasis?
Psoriasis is an inflammatory disease, so it is still debated whether it is an autoimmune disease or not – despite the tendency to think of it as an autoimmune disease with a genetic predisposition. We know that some infections can be the cause, but psoriasis is actually there.
There are some medications that can act as a “trigger” for psoriasis.
What distinguishes psoriasis? Does inflammation affect the skin only?
The lesions we see on the skin are the tip of the iceberg. There are cases when we may not notice skin lesions that are forms of psoriasis with complaints in the joints, although the anti-inflammatory process is systemic, because there is inflammation throughout the body.
There are also comorbidities associated with psoriasis that are psychological situations, such as depression, anxiety and alexithymia. Psoriasis has a powerful impact on the patient’s life. At the family level, it can be disastrous. There are, for example, cases of alcoholism, domestic violence, consecutive absenteeism and absenteeism from work. And still other conditions such as obesity, diabetes, inflammatory bowel disease, coronary heart disease, fatty liver, cholesterol and triglycerides, among others. It does not mean that they all appear, but at different stages of the disease they can manifest themselves.
Is there a drug that causes psoriasis?
There are some medications that can act as a “trigger” for psoriasis, such as anti-inflammatory drugs, lithium (used in depression), steroids or even alcohol and tobacco.
Is it possible to prevent the disease?
No, because psoriasis exists and can appear at any time in life. However, after diagnosis, it is possible to implement an effective therapeutic approach to the disease, with the aim of providing people with a quality of life. Nowadays, this is possible because we have at our disposal a good therapeutic arsenal.
There is still a huge stigma that leads a part of society to believe that psoriasis is a contagious disease
What treatments are there?
Every case is different. But I would like to stress that, for the time being, biological treatments are the safest and most effective. Although it is expensive, it is not for what it will provide in the future for a person’s life.
Is it possible to get a complete or almost complete treatment for the skin?
Today we can achieve 100% effectiveness. However, we can have cases where the effectiveness is 90% and the bad cases are 75%.
In practice, what are the most common complaints?
A form of psoriasis with joint complaints that can cause joint pain and stiffness. Another infection with extensive skin lesions causes people to have a very limited social life, not wanting to leave the house and even mingle with others. Then there are very special forms of psoriasis, like psoriasis on the genitals. In the life of spouses, this has an effect that in many cases leads to separation. Currently, there is still a huge stigma that leads a part of society to believe that psoriasis is a contagious disease, which is not true.
What myths are associated with psoriasis?
Infection is the ultimate disgust that people feel.
In Portugal, what work can be done to increase and improve knowledge about psoriasis?
Lots and I’ll explain why: As long as we prioritize football and broadcast time over health, we’re not going anywhere.
Does Covid-19 carry an increased risk for these patients?
No. For example: In the laser clinic in Belem we have about 800 patients undergoing biologic therapy. Of those, eight had Covid-19 and no problems were identified.
And in pregnancy?
A person who wants to become pregnant and who is undergoing biological treatment must cut and can only return after pregnancy. However, whether psoriasis gets worse during pregnancy varies because both conditions can occur.
Read also: Psoriasis and eczema. How do they differ?
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