Raising awareness on Psoriasis

August is Psoriasis Awareness Month.

Psoriasis is a common chronic inflammatory skin condition. It can cause red, itchy patches to develop that are covered in silvery white scales.

‘’The lesions are usually found on the extensor surfaces, such as the elbows and knees, as well as on the lower back and gluteal cleft. Special areas of involvement include the scalp, the external ear canals and sometimes the skinfolds. Nails can look very abnormal with very irregular pitting (small dents) and separation of the nail plate from the nailbed. Psoriasis can also affect the joints and cause severe destruction thereof,’’ says the Western Cape Government of Health.

PICTURE: WCGH

The condition demonstrates a bimodal distribution, with some developing the condition in early teens and others after middle-age. 1-2% of the world’s population has psoriasis. Very little is known about the exact incidence in South Africa. Psoriasis has a strong genetic background with at least seven genes having been identified up to now.

In more recent years, psoriasis has also been identified as an independent risk factor for cardiovascular disease, thereby increasing the risk of heart disease.

There is no cure for Psoriasis.

‘’Therefore, the focus is on management of the condition – educating the patient on learning to manage the disease themselves. General practitioners, dermatologists and sometimes physicians, rheumatologists and cardiologists are involved in the treatment of psoriasis,’’ said Dr Suretha Kannenberg, Consultant Dermatologist in the Department of Medicine at Tygerberg Hospital.

“Psoriasis is a very strange condition. A lesion may appear on a particular site and disappear after a few years, with new ones appearing elsewhere. This is one of the ‘koebnerising’ conditions. That means that a new psoriasis lesion can develop at areas of injuries; so, we usually recommend staying away from tattoos, for example. Stress, throat infections and certain medications, such as beta blockers and ibuprofen, can trigger a flare of psoriasis,” added Kannenberg.

PICTURE: WCGH

Treatment of skin lesions include moisturisers as well as prescription cortisone creams and ointments. A vitamin D derived ointment also plays a significant role in the day-to-day treatment. Tar containing shampoos can be very helpful for scalp psoriasis. Phototherapy of widespread disease can be very effective and is often preferred if one has access to it. For severe disease, particularly with joint involvement, medications such as methotrexate and ciclosporin A can be added to the treatment. In the last 10 years, many new highly effective medications have been developed for psoriasis treatment. Many of these are available in South Africa although their use is limited by their exorbitant costs.

World Psoriasis Day is on 29 October.

 

Done By: Mitchum George