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A condition that inflames
lifestyle October 29, 2018 01:00
By Parinyaporn Pajee
The Nation
2,152 Viewed
With the right treatment, the symptoms of psoriasis can be kept at bay. The isolation from a society that thinks it is contagious causes far more suffering
TODAY IS World Psoriasis day and hospitals across Thailand are hoping to raise awareness of this dermatological condition, which is relatively unknown here, while also updating those who suffer from it on the options available to them. The Dermatology Society of Thailand marked the occasion in advance by holding a special session for patients to share how they live with the disease and offer guidelines and advice.
In Thai psoriasis is called saged ngern, which translates as silver scales. An auto-immune disorder, it tricks the immune system into allowing the skin cells to grow too rapidly, so new cells replace old ones every other day. This results in red, raised areas of inflamed skin covered with itchy silvery-white scales. It is not contagious but because of its appearance and the lack of education about the condition, people assume it is and avoid sufferers, thus adding mental stress to the physical symptoms.
A girl from a poor family in the south of Thailand suffering from psoriasis made the headlines last year when she asked for money to help to treat the disease.
“We had stopped holding regular meetings on this condition as hospitals often provide activities. But we have decided to hold another meeting and I really don’t want our discussions today to stay in this room,” said Dr Puan Suthipinittharm, the president of the Dermatology Society of Thailand.
“I want to take this opportunity to let people learn more about the disease.” Around two per cent of the world’s population is coping with psoriasis, which affects more than 125 million people. Even though Thailand has never collected data on the condition, the estimated figure of patients is the same at two per cent, meaning that there are around a million Thais with psoriasis.”
The skin plaques take various forms, from red and white rashes on the scalp, face, soles of the feet – in fact anywhere on the body. It can be painful and chronic though those getting the proper medication can be free from symptoms for a year or two. They might also suffer from arthritis, painful joints and abnormal fingernails. Follow-up complications include diseases of the metabolic system like hypertension, cardiovascular disease and a high blood-sugar level, which can lead to diabetes. However, psoriasis can never be completely cured.
Nowadays it’s believed that there are around 25 genetic variants that make a person more likely to develop psoriatic disease though many of them will never develop symptoms at all. It is also believed that it occurs before the age of 25 and then again among the elderly. More importantly, for adult patients, symptoms are absent during childhood or adolescence.
Former finance minister Korn Chatikavanijt has suffered from psoriasis since he was 24 years old and his symptoms have appeared on and off for the last 30 years. Korn’s younger brother also suffers from psoriasis and the condition reached the stage where he needed a year’s break to take his medication.
“At that time I was somehow relieved when I started having symptoms because I felt guilty seeing my younger brother having psoriasis and my elder brother suffering from eczema,” said the politician who started having symptoms while he was busy starting a new company.
The Dermatology Society of Thailand recently hosted a meeting between sufferers and doctors.
“Psoriasis can first occur in two phases, before 25 years old and again when you grow old. Those who suffer symptoms when they are young tend to suffer more than older people who have milder symptoms,” added Dr Narumol Silpa-archa from Siriraj Hospital.
She told the meeting that psoriasis is genetic but can be triggered by outside factors such as obesity, illness, stress, alcohol, cigarettes and constant scratching.
And while there is no genetic test to find the psoriasis prevalence, the gene can be found in high levels in patients who are experiencing symptoms.
Most Thais suffering psoriasis have mild or moderate conditions and the scales are usually found in areas covered by clothes, on the head or on the back. Around 25 per cent of patients have a more severe version, covering 90-95 per cent of their body from the neck down.
Psoriasis doesn’t really show on the face or the areas where the skin is left bare as sunlight is believed to alleviate the symptoms. Aside from oral medication, injections and ointment, one of the treatments is twice weekly UV therapy.
Many Thais though, turn to the Internet, conned by promises of wonder foods or drugs of curing the disease. Such claims are false. Probably prescribed medication and the UV therapy can control it but not cure it.
But the biggest problem faced by patients is not the physical side, annoying as the condition may be, but the mental. Avoided by family, friends and the public at large, they tend to withdraw and isolate themselves for fear of public rejection. If the patients have a better understanding of the disease, they can adapt and learn to live with it, thus enjoying a better quality of life as well as a better quality of skin.
“Having psoriasis almost stopped me from entering politics because politicians have to meet people all the time and I didn’t feel comfortable when the symptoms occurred. I used to avoid eye contact with others automatically and got upset easily too,” Korn recalled.
In a reflection of how uninformed – or even misinformed – the general public is about this disease, a masseuse already abandoned by her husband because of the psoriasis patches all over her body, suffered a second blow earlier this year when her employer suspended her after customers became concerned she had Aids.
Korn Chatikavanij/ Nation photo
In another well-publicised case, a girl from a poor family pleaded for financial help to get treatment for the condition.
A man told the meeting that when his child started showing symptoms of psoriasis at the age of 12, the whole family went into a panic worrying that his younger sibling would also be affected. They even told the school not to let their child exercise to prevent the symptoms from occurring.
“I understand your worry,” Korn told him, “but I would ask you not to limit a child’s happiness. My children are now 19 and 21, they are still okay but I’ve talked about the disease and the chance it might appear in them since they were young. But I don’t treat it as being too serious and I certainly don’t allow it to kill my joy. Psoriasis can happen and we should live with it, There are thousands of things that make us happy; psoriasis is just one thing that makes us unhappy,” he added.
“Parents whose children have psoriasis shouldn’t create worry in the youngsters. It’s normal for parents to constantly check for a rash but this type of overreaction will hurt the child, especially when he or she reaches adolescence, which is when their adult personality is being formed,” says Dr Pawit.
A teacher at Thonburi Vocational College, Kanda Teekawanich says she was suffering from psoriasis and also facing an obesity problem. After losing 10 kg in four months, her psoriasis improved.
“The worst time I had was when I was finishing my thesis, it was so stressful,” she says.
But telling someone not to stress is easier said than done. Dr Puan adds that psoriasis patients must learn about the disease and their own symptoms as well as possible triggers.
“If you eat bamboo shoots and then your rash comes up, then obviously you should avoid it. If you feel relaxed when exercising, then do it. Above all, you need knowledge about the disease. We must also spread knowledge about psoriasis in Thai society so that there is a better understanding and patients are not treated as outcasts,” he says.
Many websites and online communities offer information about the disease. Patients who want to share and ask questions of doctors can visit Facebook.com/PsoriasisThailand/.
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