Psoriasis affects approximately 2.3 million people in Spain. It is a disease that manifests itself before the age of 40 in 75 percent of cases and that presents a wide range of clinical complications beyond the well-known skin plaques; the ‘visible’ trace of this pathology. For example, 30 percent of psoriasis patients will develop psoriatic arthritis, a condition that affects the joints and can have more serious consequences than psoriasis.
However, as specialists recall, psoriasis leaves its mark “beyond the skin.” A ‘footprint’, in this case, invisible. It is the way to remember its impact on the quality of life and emotional health of the patient who suffers it. This was highlighted in the virtual meeting ‘Understanding Psoriasis’, organized by GACETA MÉDICA and VERY INTERESTING, together with the collaboration of Janssen, on the occasion of the World Day of this pathology that was commemorated on October 29. “Sometimes we only show the plates or the joints, but there are symptoms related to the emotional and the psychological: anxiety, relationship problems … It is important that patients explain them in consultation,” said Montse Ginés, vice president of the association. Psoriasis action.
Although the first diagnostic approach begins in Primary Care, the course of care for the patient with psoriasis almost always begins at the dermatologist. “ In dermatology, the case of each patient is reassessed, the severity and the impact on the quality of life are established. Once all the data have been collected, the therapeutic treatment begins ”, indicated in this meeting Enrique Herrera Costa, head of the Dermatology Service of the Hospital Clínico de Málaga. This is where the perception and particular affectation — physical and, above all, psychic — that this pathology has also comes into play. “There are as many psoriasis treatments as there are patients,” Enrique Herrera Costa, head of the Dermatology Service at the Hospital Clínico de Málaga, recalled in this regard. “It is always hard to accept a chronic illness. Everyone lives it in a different way ”, the representative of Acción Psoriasis confirmed from the patient’s vision.
However, therapeutic advances have been contributing to ending, or reducing, the stigmas associated with the chronicity that psoriasis is characterized by. At the very least, from a cutaneous point of view – which, as indicated, has a direct impact on its associated invisible impact. “In just 12 years it has evolved from not having treatments to being able to cure almost one hundred percent of skin lesions, and with increasingly safer medications,” pointed out Vicente Aldasoro, rheumatologist at the Navarra Hospital Complex. “ Many patients have bleached skin but continue to think that the plaques will reappear at any moment. It is the psychological damage that psoriasis has caused them and that many cannot overcome ”, confirmed his fellow dermatologist.
“The unpredictability of whether the outbreaks will appear the next day continuously accompanies the patient”, confirmed Montse Ginés. And also, in a kind of domino effect, “the loss of quality of life affects not only the patient but also the environment,” he warned. This is where associations such as the one it represents play an important role in the training of patients and the environment and the destigmatization of this pathology. “It is very important that patients have training and information. A trained patient will be able to expose other effects to the doctor such as anxiety or psychological impact. Similarly, an informed patient will be more responsible for their treatment, adherence to it and follow healthy habits ”, explained the representative of Acción Psoriasis.
A message that the specialists endorse: “we must emphasize that certain healthy habits, such as losing weight and eating a healthy diet, will also help in obtaining results regarding psoriasis. We must be able to align ourselves with them ”, commented Aldasoro.
Coordination against “hospitalocentrism”
As indicated, psoriasis is a chronic pathology associated with various comorbidities that therefore requires a multidisciplinary approach… and coordinated.
In this sense, one of the objectives is to reduce the frequency of visits to the hospital as another ‘way’ to improve the quality of life of these patients. Avoid what in the medical community is called “hospitalocentrism”. ” The patient must have adequate comprehensive care without the need to visit the center for several days to see four different specialists ,” said dermatologist Herrera Costa to emphasize the importance of multidisciplinary teams.
