ALTHOUGH PSORIASIS is a non-curable disease, symptoms can be managed through early intervention, a proper diagnosis and the use of optimum treatment, according to an international psoriasis expert.
Treatment pathways were regularly evolving and progress had been made in treating patients as young as eight years old with biologics, said Alice Gottlieb, chairwoman of dermatology at Tufts Medical Centre in the US and professor of dermatology at Tufts University School of Medicine.
She explained that, unlike other medicines, which were made by combining chemicals, biologics were medicines that were produced or modified from amino acids, the building blocks of proteins naturally found in the body.
Up to 3 per cent of the world’s population are estimated to have psoriasis, a distressing and chronic inflammatory disease.
About 80 per cent of these patients have plaque psoriasis, which is characterised by red, scaly patches on the skin.
Severe psoriasis is also associated with a shorter life expectancy: men with severe psoriasis die, on average, three and a half years earlier than those without the disease and the figure for women is four and a half years earlier.
Prof Gottlieb addressed a Royal Academy of Medicine in Ireland psoriasis clinical meeting at the weekend, on the topic of Challenges in Modern Management of Psoriasis.
Her own research has provided new understanding of the pathogenesis of psoriasis and provided the foundation for biologic drug development in psoriasis and psoriatic arthritis.
“Psoriasis is a systemic illness; its major manifestation is obviously in the skin, but 25 per cent of moderate to severe cases develop a potentially disabling arthritis called psoriatic arthritis. We now have drugs available to us to inhibit the progress of this disease so by intervening earlier, dermatologists can prevent disability by psoriatic arthritis.”
Prof Gottlieb stressed how important it was for dermatologists to be involved in the detection of psoriatic arthritis to make sure patients get treatment early on.
She pointed out that psoriasis patients had a premature and higher incidence of death from heart attack so it was important to take the whole person into account – not just to take care of their skin but to control cardiac risk factors.
“It’s important for dermatologists to offer the full range of treatments to patients – not only light treatment, ointments and creams but phototherapy, immuno-suppressing drugs and biologics,” she said.
Prof Gottlieb explained that there was no evidence that anything a person eats or drinks could improve psoriasis – it is a genetic inflammatory disease with environmental influences. She advised patients to be cautious in their use of “natural” remedies warning that “just because it’s natural does not make it safe”.
Her advice for those with psoriasis is to do what they can to see a dermatologist who knows how to treat the disease.
