Why early diagnosis, treatment of psoriasis is helpful  

Seeking timely diagnosis and treatment of psoriasis, while recognizing the symptoms, is advisable, says a renowned dermatologist ahead of the World Psoriasis Day marked on October 29.

According to many dermatologists, people living with moderate to severe psoriasis require access to high quality treatment and regular screening of their condition. The flare-ups on the scalp, genital and palmoplantar (that affect palms and soles) may go under diagnosed by a general physician. Hence, it is important to only consult a dermatologist for correct treatment before the symptoms grow to an even more severe stage.

Contrary to the most prevalent perception of being as a mere 'skin disease', psoriasis is rather a chronic and an autoimmune condition which causes itchy, flaky, red patches with silvery scales on the skin and is often mistaken for being contagious.

It may resemble an ordinary rash. However, psoriasis occurs when the body's immune system attacks its own healthy cells. This causes an increase in new skin cells resulting in dry patches as skin cells build up on the skin's surface.

Dr Brijes Nair, Consultant Dermatologist, Military Hospital, Jaipur said, "Out of various dermatological conditions, I diagnose around 20 new psoriasis patients every month. After the diagnosis of patients' current stage, they are advised with a treatment option that varies as per their disease activity. Topical treatment can be prescribed for mild psoriasis without arthritis. Whereas, effective therapies like DMARDs and biologicals can be prescribed for patients suffering from mild, moderate to severe psoriasis on sensitive areas like palms, face, genitals, etc. which have the potential to affect their quality of life adversely. Immediate attention from a rheumatologist is required in case the treating dermatologists detects joint pain, inflammation in tendons and fingers, axial pain etc."

Although psoriasis has no absolute cure, advanced treatment options like biologics have proven to be a revolutionizing therapy for many people living with this condition. Also, this may also decrease the risk of developing co-morbid conditions. Dermatologists have observed that once patients start getting positive results, they tend to discontinue their ongoing treatment. However, it is significant to note that discontinuation of the treatment can increase the chances of developing critical co-morbidities including psoriatic arthritis, cardiovascular diseases, uveitis etc. Approximately one in four people with psoriasis have psoriatic arthritis.

After the COVID-19 outbreak it was presumed that people with auto-immune condition like psoriasis would be more prone to contracting Covid-19. This raised several questions about treatment implications and limited access to the dermatologist even forced few patients to halt their ongoing treatment. However, a recent research has found that discontinuation of the treatment can worsen a patient's existing condition and makes it difficult to manage the symptoms as they reach an advanced stage of severity.

"During the ongoing pandemic, we encourage people with psoriasis to stay in regular contact with their dermatologist and not discontinue their treatment regimen without the intervention of their treating dermatologist. As per the current recommendations, non-infected patients can continue their ongoing treatment and only Covid positive patients need to halt any systematic and biological medications as per dermatologist's advice," added Dr Nair.

Although virtual channels can be utilized to address routine problems, people should not dismiss the need to visit the clinics when required after following proper precautions like hand hygiene, social distancing norms, etc.

If not managed properly in a timely manner, psoriasis may have severe physical and emotional impact on the patient's overall health. Yet, the lack of awareness about this condition often leads to a long-term delay in diagnosis and treatment. While living with many misconceptions may negatively impact a patient's quality of life, however, being rightly educated about psoriasis management plays a huge role in the recovery process. Sometimes patients fall prey to false information and even rely on only home remedies, mostly suggested by friends and family, in the hope of getting quick relief from the psoriasis symptoms. This largely contributes to the prolonged diagnosis, and may also increase the risk of developing coronary artery disease, hypertension, diabetes, etc.

For people with psoriasis, seeking support and treatment is essential to a healthier lifestyle both physically and mentally. Therefore, an increased awareness will help psoriasis patients to recognize their symptoms subsequently resulting in timely diagnosis and treatment. Small but effective steps can facilitate the creation of an empathetic and supportive ecosystem for people living with psoriasis.