World Psoriasis Day this Thursday (29) aims to raise awareness about the non-communicable disease that causes physical and psychological suffering
More than skin disease, psoriasis affects 2.6 million Brazilians
Psoriasis is a chronic, autoimmune and non-contagious skin disease that affects about 2.6 million Brazilians, according to the Brazilian Society of Dermatology (SBD). It is characterized by red flaking plaques and in up to 60% of cases it also affects the joints. Because it directly affects appearance and is surrounded by prejudice, it also has consequences for self-esteem, social life and increases the risk of psychiatric disorders.
According to dermatologist and psoriasis specialist Dimitri Luz, from the German Hospital Oswaldo Cruz and a member of the SBD (Brazilian Society of Dermatology), the disease does not have a well-defined cause, but there is a genetic predisposition, which is an essential factor, and influence of other aspects, such as obesity and smoking.
“It is written in the DNA of the person that he is going to develop the disease. And when he comes into contact with some trigger events, the immune system starts to produce some chemical substances that cause inflammation,” he explains.
“A skin that would take 28 days to form, in individuals with psoriasis is formed in seven days. That is why that thick layer is left”, he highlights.
The parts of the body most frequently affected by injuries are elbows, knees, scalp, nails, palms and soles, according to the Ministry of Health. “Sometimes, people think they have ringworm, but they are not” , observes Luz.
“The disease gets worse when there is very strong psychological stress, unhealthy habits and lack of exercise”, he adds.
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The specialist says that between 47% and 60% of patients with psoriasis develop psoriatic arthritis, when the inflammation also affects the joints, causing severe pain – including in the spine. “This happens after psoriasis is well established, but it is not possible to establish a specific time [para o surgimento]”, details.
Higher risk of heart attack and psychiatric disorders
According to him, psoriasis also increases the risk of developing other diseases, such as heart attack, diabetes, COPD (Chronic Obstructive Pulmonary Disease) and psychiatric disorders.
The damage to mental health and social life ends up being inevitable in view of the stigma about the disease. “It is difficult to remember a patient who has not had his life changed. They face prejudice on the street. Sometimes they sit on the bus and the other person leaves his side. They receive nicknames at school. In adulthood, people keep asking” , exemplifies.
For these reasons, many try to hide the injuries and wear warm clothing, even in the heat.
“A patient who marked me a lot cried at the first appointment, because she believed she had no treatment and, when I said I was with her, that we were going to treat her, she was thrilled”, recalls Luz.
Advances in treatment
The dermatologist emphasizes that, thanks to therapeutic advances, the panorama of the disease has changed a lot in the last two decades. “It is one of the most studied diseases. Every year it ends up having a different launch. There is a lot that has emerged this year.”
There are two paths to treatment. Phototherapy booth sessions are one of them. “The person enters this cabin and receives an ultraviolet light bath”, he describes. “But not all phototherapy clinics are reliable. It is necessary to look for a doctor linked to SDB”, he guides.
In addition, it is possible to use injectable drugs. “The most advanced are the immunobiologicals. In Brazil, we have nine types available, but not all are in SUS [Sistema Único de Saúde]”, says Luz.
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According to him, immunobiologicals are remedies that block the inflammatory substances released in the body by the immune system – there is a specific drug that acts directly on each one.