Nopadon Noppakun
People nowadays may have never heard about 'Psoriasis Disease', even though it can have mentally impact to the patients and those around them directly. It can be said that people who have this disease may be avoided by the society although it is not contagious but it is an inherited disease. Believe it or not, in Thailand there are 2 psoriasis patients per 100 population or there are approximately 1 Thai million people suffer from this disease!
Psoriasis requires lots of learning and the patients should have knowledge about it. Most of the patients start to have rash and red inflamed skin during 2 spans of age, i.e. at approximately 22 years and 55 years. It is found in the adult whose ages are in ranges of 27-60 years old, both in men and women. While average ages that are found in the children are 8 year old and not younger than 15 years.
Such disorder will cause red and white rash on the body around the scalp, face, arms, hands, fingers, back and soles of feet which makes the patients feel depression and do not need to expose any part of the skin. It can affect their mentally state and career. More importantly, for adult patients, its symptoms do not show any sign during their childhood or adolescent stages. It is regarded as an autoimmune disorder that appears on the skin. It occurs because the immune system speeds up growth cycle of skin cells too rapidly and the old skin cells are replaced by new ones every other day. Such speeding skin cell growth causes red raised areas of inflamed skin covered with silvery-white scaly skin, which is very itchy. The patients have to endure irritation due to severe itching and subsequent negative conditions.
The basis of psoriasis is from genetics and it is congenital disease, which means that the patient needs to know that whose member of his family has this disease. On the contrary, it can pass via blood. When the patient is aware that he has this disease, he usually has been encouraged to stay living normally and find new way of life which means that he has to understand it, pay more attention on sunlight exposure, start to eat useful foods and avoid some types of food. Most importantly, he must be diagnosed and treated from the doctor regularly. Generally, the patients need additional assistance and mostly they need medication. There are many factors that can cause this disease, not from one specific cause, nor from pathogen, chemical substance or physics conditions which can be directly toxic to skin, but it is the effects from genetics or many kinds of abnormal genes plus improper environmental factors, both internal and external body that aggravate the condition. Skin plaques can be found in various forms, but erythematous plaque is mostly found. Some patient has acute rash and it is gone. Some has chronic recurring conditions. Other disorders which can also be found are abnormal fingernails and arthritis and etc. The patient may have abnormal fingernails or painful joint first or those symptoms may occur simultaneously with inflamed skin.
Plaque-like psoriasis is the most common form of psoriasis. It typically appears as red raised areas of inflamed skin covered with silvery white scaly skin. After scales are peeled, they will become Auspitz sign. Plaque has many forms, for example, it may be round small blisters with water drop size, or coil-size blister or larger than the palms of hands, or curve shaped. Some patients may have large plaque covering their back to hip or all over body. There are 2 patterns of plaque distributions which are commonly found. The first one appears as raised areas of inflamed skin in water drop or coil size spreading throughout the body (guttate psoriasis) but it usually occurs only for a short period of time and it is mostly found in the children after they are recovered from the infected respiratory system. This type of plaque shall be gradually disappeared after its infection has been treated but it may reoccur. The second pattern is chronic stationary psoriasis (psoriasis vulgaris or plaque type psoriasis) and it occurs in areas which have been frequently rubbed against, such as elbows, knees, hip or scalp. Its size is quite large and gradually getting bigger. It can be disappeared but it may take time and it may require proper treatment. When it is cured, psoriasis will not leave any lesions, but some patients may have black pigment but skin will become normal at a later time. About 80 percent of psoriasis patients have chronic stationary plaques. There are many types of psoriasis plaques, such as smooth inflamed patches of skin around skin folds (psoriasis inversus), raised bumps that are filled with noninfectious pustules (pustular psoriasis), widespread inflammation and fiery redness of the skin over most of the body surface (psoriasis erythroderma) and more.
Additionally, psoriasis has complications as it is found that it can cause arthritis which can affect health-related quality of life, particularly diseases concerning metabolism system, i.e. hypertension, high blood sugar level which can lead to diabetes and cardiovascular disease.
At present, teams of dermatological doctors from many institutes and hospitals throughout the country, such as Institute of Dermatology, Department of Medical Services, Ministry of Public Health; Faculty of Medicine, Siriraj Hospital; Faculty of Medicine, Ramathibodhi Hospital; Faculty of Medicine, Chulalongkorn Hospital - King Chulalongkorn Memorial Hospital; Faculty of Medicine, Phramongkutklao Hospital; Faculty of Medicine, Chiangmai University; Faculty of Medicine, Prince of Songkhla University, the center hospitals and general hospitals in the regions place importance to this disease. Dermatological Society of Thailand deems that this disease should be widely publicized, so that the general public and close relatives of the patients can acknowledge about its characteristics, conditions, and above all they shall be well aware that psoriasis is not contagious. For alternative treatment guidelines, Dermatological Society of Thailand by the support of LEO Pharma shall further publicize at the later stage, so that the psoriasis patients can be treated with holistic approach. If the doctor has diagnosed that anyone has psoriasis disease, there may be many questions, for instance why it has strange name, or will it spread throughout the entire body or not, how to cure it or is it a chronic disease or not. When the patient has been informed that it cannot be cured, they may have emotional problems, such as stress, major depressive disorder or social isolation for fear of public rejection. If the patients have better understanding about this disease, they can adapt themselves and can live with it more happily and have a better quality of life as well as a better quality of skin.
credit: http://www.nationmultimedia.com
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