Dr Prof Sujay Khandpur, Dermatology, AIIMS Hospital, said, “Psoriasis is a multifactorial disease, which means there are many factors that precipitate or exacerbate or increase the incidence of psoriasis.One of them is stress. It could be physical stress or physiological stress. or emotional stress. It could be trauma. So a patient who gets trauma in any part of the body is suffering from psoriasis can continue to get new lesions at the sites of trauma.”
Psoriasis is a very common skin disorder and we see a lot of patients in our hospital suffering from this disease. It’s a chronic disease and that comes from inside. One of them is genetic factors, the doctor added.
“It’s an inflammatory disease and what we refer to as an immune-mediated disease, where there is some inflammatory infiltrate that comes into the skin. As a result of this, there is increased proliferation of the skin cells which leads to the development of psoriasis,” he said.
Also, the doctor said that infection is an important precipitating cause. So if a patient develops a sore throat infection urinary tract infection ear infection, or lung infection, there are greater chances of patients having precipitation from the psoriasis in patients who already have psoriasis.
“There are certain medicines that are given for various diseases that can also precipitate psoriasis. So one has to be very, the skin specialists wrote about this set of medications that can increase psoriasis but it has to be recognized that this increases only in patients who are genetically predisposed to develop psoriasis with those medicines,” said the doctor.
It does not mean that every psoriasis patient who takes those medicines will have a flare or increase in psoriasis. So there is a subgroup of those patients where psoriasis can increase, he added.
As per the doctor, psoriasis normally manifests as red-coloured patches with white-coloured scales, and they’re normally present on the extensor aspects such as the back portions of the body, not the front portions of the body. They will be present in large numbers on the back of the limbs, arms and legs or on the back.
The patches could also be present in trauma-prone areas on bony prominences and they can also be prepared they can also be present on the scalp, but we refer to it as scalp psoriasis, again, involves the noose, which we refer to as nail psoriasis, he said.
They can involve the various body folds, and we refer to that as flexural psoriasis. They can only involve the palms and the sores and you can understand that psoriasis which causes the skin to become red, dry, thick, and cracked.
An important thing that doctors say is that this disease can increase more in winter, that is, there is a higher risk of spreading this disease in winter, said the doctor.
Dr Sujay said, “About 45 to 50 per cent of Psoriasis patients show an exacerbation during winters. Otherwise, sometimes the psoriasis can also increase in summer. But yes, there is a slightly greater winter exacerbation.”
There is no solid evidence specifically for environmental factors or pollutants to be directly responsible for psoriasis.
But certainly, reduction in pollution and reduction in these noxious environmental factors can play an important role in treatment or decrease in the intensity and severity of psoriasis and therefore the need to give fewer drugs and for a shorter period of time, said the doctor.
Psoriasis not only causes physical impact, but it also has a huge psychosocial impact. You can understand that a patient with psoriasis has red patches, lots of scales, and scales falling all over, and he goes to the office or if it’s a child suffering from psoriasis and goes to school, he is shunned by his peers, he said.
The person is shunned by his teachers, colleagues, and others, therefore it causes significant psychosocial impact designs or cosmetic impact on the patient. It leads to very low self-esteem for the patient reduces his mental development and leads the patient to prevent depression and a significant amount of anxiety.
The doctor further added that both mental stress and physical stress or physiological stress can precipitate psoriasis.
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