REGIONAL NEWS - In honour of August being Psoriasis Awareness Month, the Western Cape Department of Health (DoH) is raising awareness of the condition and everything about it.
According to the DoH, psoriasis is more common than we think: up to 2% of the world's population has the condition.
Very little is known about the exact incidence in South Africa. Of course, the majority will have it in a mild degree - maybe just a scaly area on the elbow or scalp. Very severe cases can be very debilitating, leading to profound embarrassment and even to disability.
It is thought that psoriasis patients were shunned from society in biblical times already, when it was often confused with leprosy.
Psoriasis has a strong genetic background with at least seven genes having been identified up to now. The condition demonstrates a bimodal distribution, with some developing the condition in early teens and others after middle-age.
The condition is characterised by red patches with silvery white scales. They can sometimes itch significantly. 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 skin folds. Nails can look very abnormal with very irregular pitting (small dents) and separation of the nail plate from the nail bed. Psoriasis can also affect the joints and cause severe destruction thereof.
In more recent years, psoriasis has also been identified as an independent risk factor for cardiovascular disease, thereby increasing the risk of heart disease.
Psoriasis is a chronic condition with no available cure. Therefore, the focus is on management of the condition - educating patients on learning to manage the disease themselves. General practitioners, dermatologists and sometimes physicians, rheumatologists and cardiologists are involved in the treatment of psoriasis.
"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,"said Dr Suretha Kannenberg, consultant dermatologist in the Department of Medicine at Tygerberg Hospital. "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."
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 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 cost.
In recent years, celebrities such as Kim Kardashian and pro-golfer Phil Mickelson have shone the light on psoriasis, raising awareness of this age-old disease. It is now well known that psoriasis is more than skin deep.
More information, as well as the Facebook link to our local support group, can be found at http://www.psoriasis.org.za/. Also keep an eye out for World Psoriasis Day celebrations on 29 October.
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