What is Psoriatic Disease?

牛皮癬 | 乾癬 | 건선 | सोरायसिस | সোরিয়াসিস | Soryasis | โรคสะเก็ดเงิน | Bệnh vảy nến | Psoriasis | சொரியாசிஸ் | چنبل

Psoriatic disease encompasses a spectrum of chronic, immune-mediated conditions, primarily manifesting as psoriasis and psoriatic arthritis. These conditions not only affect the skin and joints but also carry significant systemic implications, including cardiovascular disease, diabetes, and mental health disorders. This evolving understanding highlights the need for comprehensive care and patient advocacy worldwide.

Psoriasis

Psoriasis is a chronic autoimmune disease characterized by the rapid turnover of skin cells, which leads to thickened, scaly patches on the skin. These plaques often appear on the scalp, elbows, knees, and lower back but can occur anywhere on the body. Psoriasis is not just a skin disorder but a systemic inflammatory condition that can significantly impact a patient’s quality of life.

The severity of psoriasis varies, ranging from small, localized patches to widespread plaques covering a significant portion of the body. Symptoms include:

  • Plaques: Raised, inflamed, and scaly patches of skin.
  • Itching and Discomfort: A common feature that can disrupt daily life.
  • Nail Changes: Thickened or pitted nails, sometimes separating from the nail bed.
  • Joint Pain: A sign of psoriatic arthritis, which occurs in about 30% of people with psoriasis.

Types of Psoriasis

  1. Plaque Psoriasis: The most common form, accounting for about 80-90% of cases.
  2. Guttate Psoriasis: Small, dot-like lesions, often triggered by infections like strep throat.
  3. Inverse Psoriasis: Affects skin folds, such as under the breasts or around the groin.
  4. Pustular Psoriasis: White pustules surrounded by inflamed skin.

Erythrodermic Psoriasis: A severe and rare form causing widespread redness, scaling, and discomfo

The Psoriasis Resolution
at the World Health Assembly (2014)

In May 2014, the World Health Assembly (WHA) adopted the Psoriasis Resolution (“WHA67.9”), marking a historic milestone in the recognition and management of the disease. This resolution resulted from extensive advocacy by patient organizations, the International Federation of Psoriasis Associations (IFPA) members, and other global stakeholders.

The Psoriasis Resolution redefined how psoriasis is perceived and managed worldwide. Key outcomes included:

  • Recognition of Psoriasis as a Serious NCD: The resolution acknowledged psoriasis as a non-communicable disease (NCD) with significant physical, psychological, and social burdens.
  • Focus on Stigma and Discrimination: It highlighted the need to address the stigma and discrimination faced by individuals living with psoriasis.
  • Advocacy for Universal Health Care: It encouraged governments to include psoriasis in their national health strategies, ensuring equitable access to diagnosis, treatment, and care.
  • Promotion of Research and Awareness: The resolution underscored the importance of investing in research and increasing public awareness about psoriasis.

This global acknowledgment has fueled advocacy efforts to improve patients’ lives, ensuring that psoriasis is no longer seen as merely a cosmetic condition but a complex disease with systemic implications.

Psoriatic Disease: Beyond the Skin

Psoriasis is more than a skin condition. It is part of a broader category known as psoriatic disease, which includes psoriatic arthritis and other comorbid conditions. These systemic manifestations underscore the need for a multidisciplinary approach to care.

Psoriatic Arthritis (PsA)

PsA is inflammatory arthritis that affects the joints and entheses (where tendons and ligaments attach to bones). Symptoms include joint pain, stiffness, and swelling. If untreated, it can lead to permanent joint damage.

Comorbidities

Psoriasis is associated with several comorbid conditions, including:

  • Cardiovascular Disease: Increased risk due to chronic inflammation.
  • Diabetes: Greater prevalence in individuals with psoriasis.
  • Mental Health Issues: Depression and anxiety are common due to the psychological impact of living with a visible and chronic condition.
  • Obesity and Metabolic Syndrome: Often intertwined with psoriasis.

Addressing the Challenges

Despite advances in treatment and advocacy, significant challenges remain:

  1. Access to Care: Many patients, especially in low- and middle-income countries, lack access to proper diagnosis and treatment.
  2. Stigma: Misconceptions about contagious psoriasis affect patients’ social and professional lives.
  3. Holistic Care: There is a need for integrated care that addresses the disease’s physical and psychological aspects.

The 2014 Psoriasis Resolution has empowered patient organizations to advocate for better policies and healthcare services. By fostering collaborations among healthcare providers, policymakers, and patient communities, we can address psoriatic disease holistically. The ultimate goal is not just managing the disease but improving the overall quality of life for millions of affected people.

Psoriatic Disease: Beyond the Skin

Psoriasis is more than a skin condition. It is part of a broader category known as psoriatic disease, which includes psoriatic arthritis and other comorbid conditions. These systemic manifestations underscore the need for a multidisciplinary approach to care.

Psoriatic Arthritis (PsA)

PsA is inflammatory arthritis that affects the joints and entheses (where tendons and ligaments attach to bones). Symptoms include joint pain, stiffness, and swelling. If untreated, it can lead to permanent joint damage.

Comorbidities

Psoriasis is associated with several comorbid conditions, including:

  • Cardiovascular Disease: Increased risk due to chronic inflammation.
  • Diabetes: Greater prevalence in individuals with psoriasis.
  • Mental Health Issues: Depression and anxiety are common due to the psychological impact of living with a visible and chronic condition.
  • Obesity and Metabolic Syndrome: Often intertwined with psoriasis.

Addressing the Challenges

Despite advances in treatment and advocacy, significant challenges remain

Access to Care

Many patients, especially in low- and middle-income countries, lack access to proper diagnosis and treatment.

Stigma

Misconceptions about contagious psoriasis affect patients’ social and professional lives.

Holistic Care

There is a need for integrated care that addresses the disease's physical and psychological aspects.

The 2014 Psoriasis Resolution has empowered patient organizations to advocate for better policies and healthcare services. By fostering collaborations among healthcare providers, policymakers, and patient communities, we can address psoriatic disease holistically. The ultimate goal is not just managing the disease but improving the overall quality of life for millions of affected people.