New Delhi: Psoriasis is a chronic condition related to the immune system, affecting more than 125 million people worldwide. India contributes to 20% of the global disease burden, with approximately 25 million psoriasis patients nationwide.  Furthermore, 1 in 3 psoriasis patients in India suffer from a moderate to severe condition.


Psoriasis is not just a skin disease. It is a chronic, autoimmune, disabling disease associated with significant negative impact on patients’ quality of life. 1% to 4% of the population is affected by Psoriasis. The condition needs to be treated by a dermatologist, addressing the systemic inflammations and underlying cause of disease.


Prompt detection and treatment are necessary to manage the condition effectively.


With the rising burden of COVID on health systems in the country, and the rise in COVID-related stressors contributing to altered lifestyle patterns and stress, it is even more vital to effectively diagnose and manage chronic conditions like psoriasis. One key aspect of this is ensuring continued adherence to prescribed therapy, and consulting one’s dermatologist to address any growing concerns.


Understanding Psoriasis 


Often perceived as a skin and cosmetic condition, psoriasis is an autoimmune condition. This causes inflammation that speeds up skin cell growth, resulting in itchy or painful, thickened, red, inflamed plaques (patches) on the skin, which can often appear as silvery scales. Plaques and scales may appear on any part of the body, although they are commonly found on the elbows, knees, and scalp. 


In moderate to severe cases of psoriasis, as much as 10% or more of the body can be affected. Psoriasis can occur at any age, although onset has two peak periods: between 20 and 30 years and between 50 and 60 years of age. Several factors contribute to the condition, including heredity, stress, infection and temperature.


Although the condition flares up or worsens at times, it can be easily and effectively managed, with treatment modalities depending on disease severity.


Despite its high prevalence, psoriasis is still poorly understood. Misconceptions among the public, such as believing the condition is contagious, result in stigmatisation surrounding psoriasis.


This can have profound impacts on the patients’ quality of life, personal relationships and social interactions, including at work. Moreover, it can contribute to mental health issues, such as depression. 


1 in 3 Psoriasis Patients Develop Psoriatic Arthritis


Approximately one in three people with psoriasis patients go on to develop psoriatic arthritis. 


Psoriatic arthritis encompasses stiffness, swelling and pain in joints and surrounding areas. The condition can start at any age, but commonly start between ages 30 and 50. It may take a few consults with healthcare providers to diagnosis psoriatic arthritis, which is a key problem to address.


It is important to identify and treat psoriatic arthritis early on to avoid permanent joint damage. Roughly 30% of psoriasis patients have joint problems as well. There is a need for streamlined communication between dermatologists and rheumatologists, to ensure psoriatic arthritis does not go undetected. If untreated, it can cause permanent joint damage in as little as six months. Timely detection and treatment, with continued adherence, can help manage the condition effectively.


Across both psoriasis and psoriatic arthritis, advanced, trusted treatment solutions such as biologics can help meet patient need gaps. Advanced treatments, especially in more moderate to severe cases, can be vital to support patients manage flare ups, which can occur very suddenly as a result of triggers like stress.


Results of treatment can be life-changing, alleviating symptoms and even offering the potential of clear skin. Owing to the lifelong nature of the condition, raising awareness about psoriasis is necessary to ensure people seek early diagnosis and treatment, while simultaneously destigmatising the condition.


Dr. Rajiv Sekhri is a dermatologist at Fortis Hospital in New Delhi.