Psoriasis: a stigmatizing but treatable disease

A few days ago we were able to read the results of a study conducted at the University Hospital of the Canary Islands, where it was found that 8 out of 10 people suffering from psoriasis feel that this disease is a stigma in their lives.

These data, although novel because of the large sample of patients (more than 200) and because of their design, nevertheless do not surprise me that much. The truth is that every day, when I talk to people suffering from psoriasis in my office, I can perceive that they present different “secondary” alterations to the disease, which are as important or even more important than the psoriasis itself.

The most frequent problems that I observe in my patients in the 10 minutes that a dermatological consultation usually lasts are: sadness, nervousness, insecurity, lack of self-esteem, carelessness in personal care and overweight.

But something that worries me even more is the mistrust I see in patients’ eyes, mistrust of both the doctor and the treatments for psoriasis. However, the truth is that I can understand why we have reached this situation. In the past, and still sometimes today, there are two fundamental problems in the medical care of people with psoriasis.

First, either because of lack of time or because the patient or the dermatologist himself is not concerned about the “side effects” of the disease, it happens that after the consultation the patient goes home with his treatment prescription but without having explained the other essential issues. Such as alteration in their quality of life due to itching, pain or aesthetic alteration, embarrassment, depression, insecurity, pain or inflammation of the joints and a long etcetera.

Second, until a few years ago, available treatments for psoriasis were limited in both number and efficacy. They were also inconvenient to use because of their bad odor, staining of clothes or long absorption time. Time and situations that many cannot afford.

However, thanks to studies such as the one conducted at the Hospital de Canarias and the recognition of psoriasis as a multisystemic and metabolic disease with multiple repercussions on the body and mind, the medical view of this disease has changed.

Dermatologists have become aware of the great problem of psoriasis. We have understood that the aesthetic alteration it produces is the least important.

We now have multiple effective treatments for psoriasis and its many consequences, both physical and psychological. They are not like before, they are better and varied. And the outlook for the coming years is encouraging as molecules targeting the type of inflammation that occurs in psoriasis continue to be developed.

I believe that we dermatologists have an obligation to change the current situation of patient mistrust acquired in the past. They lack our time, our interest in all their problems, a complete information about the different treatments and an individualization of the treatments according to the needs of each patient.

In my opinion, psoriasis patients deserve specialized care by experts in multidisciplinary units where they can be seen by dermatologists, psychologists and rheumatologists, when necessary.

I am sure that with everyone’s effort we will achieve that this disease, which can be so serious, is recognized and treated as it deserves.