Understanding Psoriasis

Manila Bulletin, November 23, 2008

Psoriasis is a chronic skin disorder that is characterized by thick, red, and scaly patches on the skin, inflammation, and excessive skin production with a silvery white appearance. Depending on its severity, psoriasis can cover the whole body or just a particular area, frequently the skin of elbows and knees, scalp, and even the genitals.

The condition is non-contagious but recurring, and it can also affect the fingernails and toenails (psoriatic nail dystrophy) and the joints (psoriatic arthritis). Psoriatic arthritis can be disabling, deforming, and devastating to the patient, especially when the effect becomes permanent.
Although considered as one of the longest known skin illnesses, the cause of psoriasis is unknown, though it is significantly linked -- but not exclusively -- to genetics. Other factors that can aggravate psoriasis are stress, excessive alcohol consumption, and smoking.

Psoriasis can affect any age group, but it commonly manifests between the ages of 15 and 25. Treatments for the disease are expensive and only offer control. While ointments and other products can help relieve itchiness and pain, and reduce dryness and redness, these treatments cannot end psoriasis.

"It is poorly understood how [psoriasis] came about, so treatment is also [elusive]," explains Dr. Lorna Frez, dermatologist and convenor of the Psoriasis Support Group of St. Luke’s Medical Center. "And because the skin is an external organ and...society judges [us] by external appearance, that is the biggest problem of a patient with psoriasis. They go [into] self pity; they confine themselves at home; they isolate themselves; and they don’t socialize. Some people don’t marry, not only because they might (pass it on) to their [offspring] but also...they don’t have (the) confidence to be with a partner."

Edmund Carino, 29, discovered his condition in 2005. He had himself checked after he developed rashes on his body that didn’t disappear after treatment with anti-fungal. After a biopsy and thorough examination, he learned he had psoriasis. He used to work in a water company, but because of his condition, he was forced to quit his job. After several months, it developed into psoriatic arthritis, and he could not even stand anymore. He was bedridden and confused about his illness.

"At first, when I (encountered) people who (didn’t) know me and my illness and they (looked) at (me) from head to foot, I really got pissed off. But after a while, I got used to it. My friends and family already know about my condition, so it doesn’t matter anymore," he shares.

Today, Edmund needs expensive medication which costs P18,000 per week. It has allowed him to walk again and ease the itchiness and pain of his psoriatic arthritis. His deformed fingernails and toenails are slowly going back to normal. He says he has already accepted his condition and chooses to be happy in life despite it.

Psoriasis affects millions of people worldwide. In the Philippines, an estimated 170,000 Filipinos have reported cases of psoriasis, while there are more who don’t seek medical care.
Most patients lose their jobs and become bed-ridden when afflicted with severe psoriasis, and their quality of life is significantly reduced.

This prompted a group of dermatologists at the St. Luke’s Medical Center to organize a support group for psoriasis patients. Their aim is to improve patients’ lives by conducting patients-to-patients interaction for support and sharing experiences, nutrition and exercise information, sessions with psychologists, and spirituals guidance.

"We want more people to understand and care about psoriasis because this should not stop patients from living normal lives, becoming gainfully employed, and becoming useful in the society," explains Dr. Frez.

"We already have existing patients who managed (to) overcome their situations (through the) proper and thorough information given by their doctors. Now, they are the ones inspiring other patients with the same condition to do the same. They are also very instrumental in (informing) the public what psoriasis is all about," ends Dr. Frez.