Targetted therapy can give prolonged remission from psoriasis, says expert

Psoriasis, a chronic skin disorder, affects millions globally with various triggers and treatment options explained by Dr. Chalam.

Psoriasis, an immune system dysregulation disorder, can lead to chronic, sustained inflammation of the skin. Its prevalence ranges between 0.44 % and 2.8 % in India and affects around 60 million globally, says K. Venkata Chalam, president of the North Andhra Association of Dermatologists, Venereologists, and Leprologists (NAADVL).

The incidence of psoriasis is on the rise due to co-morbidities like obesity and stress in those with a family history of the disorder. Left untreated, it can cause collateral damage. Infections, trauma, and certain drugs can trigger the disease in those with a genetic predisposition. Though there is no cure for psoriasis, there are targeted therapies that can offer remission for longer periods and reduce the risk of collateral damage, Dr. Chalam told The Hindu on World Psoriasis Day.

“The interplay of genetic background, environmental factors, and Th 17 immune cells contribute to the pathophysiology of psoriasis. It can affect men, women and children. The reddish bumps covered with silvery white scales are typically localised to trauma-prone areas like elbows, kneecaps, umbilicus, trunk, and scalp,” he says.

“Those with scalp lesions and nail changes are more likely to develop psoriatic arthritis. The lesions in psoriasis are dry, scaly, and associated with intense itching and pain. Apart from this, variants like guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis can occur. Few of the severe variants require hospitalization and intensive care.”

“Psoriasis occasionally can pose a significant challenge in diagnosis because of many variants, and further, it can be misdiagnosed as it can mimic other skin diseases. Factors that can trigger psoriasis include certain infections, like streptococcal tonsillitis, and drugs like painkillers and antimalarials. Psoriasis can be associated with other co-morbidities like metabolic syndrome with an increase in weight and associated elevated blood sugar levels, increasing lipid levels, and hypertension. This can further lead to non-alcoholic fatty liver disease, diabetes, and cardiovascular disease,” says Dr. Chalam.

Patients should inform dermatologists if they suffer from early morning stiffness and joint pain to facilitate early recognition of arthritis. Furthermore, 30% of psoriasis patients can develop psoriatic arthritis, which can involve small joints and spondylitis.

“Targetted therapy with biologic injections can give prolonged remission and halts the progression of cardiac involvement. It has been observed that blocks were getting cleared due to these injections,” he said.