Dealing with psoriasis
Medical experts discuss ways and means to tackle the disease among children
With groundbreaking treatment options being discovered at a rapid pace, life for psoriasis patients has taken a turn for the better over the past decade and a half.
We now know that psoriasis is not just a skin disease. Chemicals and cells involved in the inflammation have been found to be not only responsible for red scaly patches and plaques on the skin but also joint swellings, pain and many other problems.
An inflammatory systemic disease, psoriasis is often associated with diabetes, heart disease, joint swellings, inflammatory bowel disease, depression and even cancer. It affects about 2.5-3 per cent of the world population; that is about 125 million people regardless of age, gender, ethnicity and socio-economic status. About one third of adult patients develop the disease in their childhood.
Like adults, children too get red scaly patches and plaques on elbows, knees and scalp; but unlike grown-ups, children’s face and even eyelids can get affected, says Dr Srikumar Goturu, Specialist Dermatologist and Medical Director at Dr Joseph’s Polyclinic in Karama.
Paediatric psoriasis can be difficult to diagnose. Irritations that look like a diaper rash but doesn’t respond to treatment may be psoriasis. Teardrop-like scaly patches that appear on the body after a throat infection can be psoriasis too.
“The management of paediatric psoriasis is more important as it is well established that children with psoriasis commonly become obese, develop blood pressure, diabetes and high cholesterol, and are also more likely to have ischemic heart disease, arthritis and even inflammatory bowel disease, not to mention the psychosocial impact,” explains Dr Goturu.
About 19 per cent of the affected children get psoriatic arthritis — pain in their joints — compared to 30 per cent of the adults with psoriasis.
“Good treatment is a combined effort of a dermatologist, paediatrician, rheumatologist, nutritionist, psychologist, counsellor, the parents and the child,” he adds.
Various studies have discovered that the cost of caring for psoriasis patients can be more than the cost of treating heart attacks, cancers, or even serious road traffic accidents.
“Recent advances in our understanding of psoriasis and the many new medications that are available have revolutionised the management of the disease,” he says. The US National Psoriasis Foundation has declared complete cure of psoriasis as a goal. Although that seems difficult at the moment, it is possible to control psoriatic disease to almost 100 per cent nowadays, explains Dr Goturu.
Creams, lotions and shampoos are the first line of treatment. If the condition is severe, phototherapy is used.
Amber Clinics provides all the treatments licensed in Dubai. The most modern — the biologic treatment — has been in use for four years. “When pioneering biologic treatments for paediatric psoriasis are used judiciously, they can vastly improve the quality of life of the child as well as the family.
“We have an excellent protocol for the treatment of the disease and have been using all the recent medications with good outcomes as borne out by our patients.”
Effects of paediatric psoriasis
1. Low quality of life; 2. Disruption in family and social relationships; 3. Interferes with play and sport; 4. Affects normal development
How it affects adults
1. Embarrassment and isolation; 2. Low quality of life; 3. Anxiety and depression; 4. Associated problems such as hypertension, obesity, diabetes and metabolic syndrome; 5. Joint swelling and pains; 6. Absenteeism and job loss; 7. Sexual issues and marital problems; 8. Diet and lifestyle; 9. Networking
Lending a helping hand
Launched six months ago at Dr Joseph’s Clinic Karama, the Psoriasis Support Group provides patients a platform to understand the disease better. “Our main aim is to empower psoriasis patients through education and support,” says Dr Srikumar Goturu. “The interactive group offers an effective platform for patients to enhance their quality of life.” The unsightly appearance of the plaques, irritation and pain as well as the long-standing nature of the disease usually isolate patients. Discussions with their doctor about shared problems and concerns enhance understanding of the disease, which relieves emotional burden and anxiety. The patients recognise that they are not alone. To enrol in the Psoriasis Support Group, call 04 337 8828 or email docsrikumar@gmail.com
PATIENTS REVEAL THEIR PSORIASIS JOURNEY
“Diagnosed with psoriasis 12 years ago, I’d learned to accept the plaques on my body and adopted a dress code that concealed them. Over the years I’ve tried to understand the triggers and changed my lifestyle for better. I’ve been managing the condition on my own. However, things changed drastically two years ago, when a pain in the knuckle started to increase gradually, making it almost impossible to carry out simple daily tasks. I was then diagnosed with psoriatic arthritis. Although I learnt a lot about my condition and how to deal with it on the net, denying medication due to the high cost associated with the biologics vaccination worsened my condition. A year later when I couldn’t manage the pain anymore, my doctor, Srikumar Goturu, suggested trying a cheaper alternative oral drug. It turned out to be a lifesaver. Today I’m a happier person and try to give back by working closely with the doctor on the Psoriasis Support Group, helping people with similar issues.”
Deepa C.
“I was diagnosed with psoriasis eight years ago. I found it difficult to deal with the disease in the initial days. I met a lot of doctors and was advised different medications. I met Dr Srikumar Goturu about 18 months back. Things have improved drastically since. As the treatment was very expensive, he guided me to different charitable institutions for my medication. Being part of the Psoriasis Support Group has also helped me immensely. Sharing our experiences with each other gives us the feeling that we are not in this alone.”
Rakesh Singh