Chandigarh : Psoriasis is a common chronic skin disease affecting about 3% of the world population. It can affect any age, sex or race. It is an immunologically mediated disease influenced by genetics, personal and environmental factors. The most common pattern is chronic stable plaque psoriasis. The psoriasis patches tend to appear symmetrically, most often on the knees, elbows, trunk and scalp, though any area can be involved. These plaques appear as well defined red patches covered with silvery white scales associated with itching. The severity of psoriasis varies with time, and from person to person. The number of psoriasis patches may vary from few to all over the body. Apart from skin, joints and nails can also be affected in 10- 40% patients. Infections, stress, alcohol, smoking and trauma are the aggravating factors. Psoriasis patients have increased predisposition for hypertension, diabetes, hyperlipidemia and coronary artery disease (metabolic syndrome). Psoriasis patients may suffer from cosmetic disfigurement and hence face social stigma. More than anything, they sometimes bear the brunt of public rejection because of the misunderstanding surrounding the disease.
29 October is World Psoriasis Day. World Psoriasis Day is an annual day specially dedicated to people with psoriasis/psoriatic arthritis. Conceived by patients for patients, World Psoriasis Day is a truly global event that sets out to give an international voice to the 125 million people with psoriasis/psoriatic arthritis all over the world to raise awareness about this disease and give people with psoriasis the attention and consideration they deserve. The theme for 2012 world psoriasis day is “Psoriasis – a global health challange“. The aim of observing World Psoriasis Day is to help psoriasis patients to recognize their own disease and seek treatment, enable public to realize that psoriasis is not contagious and halt discriminating behavior, and to facilitate the medical community for diagnosis and effectively treat the disease.
Department of Dermatology, Venereology & Leprology at PGIMER, Chandigarh is one of the first centres in Asia to start Psoriasis Clinic. Till date more than twelve thousand patients of psoriasis have been registered in the clinic. Department has done pioneer work on the epidemiology and treatment aspects of psoriasis in India. Dr Sunil Dogra, Associate Professor of Dermatology at PGI said that prevalence and morbidity of psoriasis in increasing in India due to modern stressful life style, lack of adequate physical activities and associated risk of metabolic syndrome. Dr Dogra was invited at 3rd World Psoriasis and Psoriatic Arthritis Conference held at Stockholm in July 2012 to deliver a lecture on “Psoriasis in India – treatment issues and challenges”.
Analysis of data from psoriasis clinic at Dermatology Department, PGI revealed that Psoriasis account for 2.3% of the total dermatology outpatients. There was a distinct male preponderance. Mean age of onset was lower in women at 27.6 years, although the severity of the disease was the same in both sexes. Family history was positive in just 2% of patients. Plaque type disease was the most common, seen in over 93% of the patients. The scalp was the first site of onset in 25.2%. Nail and joint involvement were seen in 55.7% and 4.4%, respectively. Complete remission of disease activity was experienced by 35% of the patients mostly during summer in the course of their disease.
In a study of 419 children seen at the Psoriasis Clinic of PGI over a period of 13 years, there were 219 (52.2%) boys and 200 (47.7%) girls, with a male to female ratio of 1.09 : 1. The age of onset ranged from 4 days to 14 years. A positive family history was present in only 19 (4.5%) patients. The extensors of the legs were the most common initial site affected [105 (25%) cases], followed by the scalp [87 (20.7%)]. Classical plaque psoriasis was the most frequent clinical presentation [254 (60.6%) patients], followed by plantar psoriasis [54 (12.8%)]. Itching was the most frequent symptom, reported by 365 (87.1%) children. PGIMER has evolved systemic methotrexate regimen in psoriasis which is followed all over the world. Phototherapy of psoriasis was for the first time started at this institute in Northern India. Besides, department of Dermatology has done landmark work on topical coal tar, dithranol, hydroxyurea, acitretin and cyclosporine in psoriasis.
Topical therapies (creams/ointments/lotions) are the mainstay of treatment for mild disease where as severe disease can be effectively managed through various systemic drugs and phototherapy. Patients not responding to conventional drugs can be effectively managed with biologic therapy. Many new innovative topical and systemic therapies of psoriasis are under development for an effective treatment of psoriasis patients. A positive life style, stress management, weight control, yoga, meditation and walk is essential component of disease management.
Essential Facts about Psoriasis
- Psoriasis can affect anyone, anywhere, psoriasis knows no borders
- Psoriasis is not infectious or contagious
- Psoriasis patients should keep their weight, blood pressure and cholesterol under control
- Avoid alcohol intake and smoking
- There is no apparent relationship between diet and psoriasis
- Stress management is helpful for disease.
- Have a positive attitude in life and self confidence
- Always use the treatments prescribed by a qualified dermatologist
- Treatment by quacks, advertised over internet with promising claims, having no scientific basis often makes disease worse and non responsive to usual medication.
- You should be regular in follow up with your treating doctor, avoid self medications
- Psoriasis patients can lead a normal life
- Keeping skin moist with oils and sun exposure is beneficial
- Discuss your problems of psoriasis with your dermatologist, become partner in treatment decisions.
Sir.i m very upset..due to my wife psarorises decases. In shimla Dr. A ur again soon give me homepatic medicine.. but medicine hve no name.dr always make 8000 bill every 2&3 week. But caure nahi ho raha… send me feedback.. I m thankfully to your faith.