Psoriasis is a chronic disease, which cannot be cured, but which is now being controlled better and better. In fact, in recent years new medicines have arrived that have made it possible to achieve a previously unthinkable goal: to have clean skin, free from reddish patches and covered with scales (typical manifestations of the disease) and without the itching and embarrassment that often accompany them. “It affects about two million Italians and it is important to remember that it is neither infectious nor contagious – recalls Francesco Cusano, president of the Italian Hospital Dermatologists Association (Adoi) -. Although it is not yet possible to permanently cure psoriasis, there are numerous therapies available and able to cure even the most severe manifestations of the disease, both on the skin and on the joints, obtaining excellent control ».
Since this is a chronic disease, with a course defined as “relapsing” (that is to say at times it disappears or worsens), the people who suffer from it must, however, follow therapy for very long periods. As emerged from a meeting organized on 8 October at Corriere della Sera, dissatisfaction and lack of adherence to prescribed treatments are still a widespread problem among people who have to live with this disease and it is on this front that the role of scientific research is crucial. “We need a constant relationship of trust between patient and specialist – adds Cusano, director of Dermatology at the San Pio-Gaetano Rummo Hospital in Benevento -. It is important to talk to your dermatologist to get a personalized treatment, the most suitable for the individual case, to be modified over time according to the needs and changes in the pathology “.
It’s not just about the skin
The lesions can occur at any age, even if the peak of onset is recorded between 20 and 40 years, and in recent years it has become clear that it is a systemic disease, that is associated with many other diseases (those that specialists call comorbidity): first of all psoriatic arthritis, which affects up to 30% of patients, but the list is long and includes joint, metabolic, cardiovascular and intestinal disorders. “Although it manifests itself with lesions on the skin, the psoriasis is not “only” a skin disease, but a condition that can seriously compromise the psycho-physical well-being of those affected – underlines Ketty Peris, president of the Italian Society of Dermatology SIDeMaST and director of the Dermatological Clinic at the Catholic University of Sacred Heart Polyclinic Gemelli of Rome -. The severity of the disease is measured based on the extent of the lesions (and the affected areas, because some such as the face, hands, feet or genitals can be more disabling); the degree of erythema, peeling and infiltration; the response to therapies and the degree of social and psychological disability it causes to the sick ». In fact, especially in people with severe forms, anxiety and depression are very common. Even in order to better follow the patients, providing everyone with the best assistance and care, early diagnosis is a fundamental step.
Patient requests
«Despite being a chronic disease, which can cause serious discomfort, psoriasis is not included in the National Chronicity Plan – says Tonino Aceti, president of Salutequità -. Instead, it is urgent, because it is a decisive step for a timely and more structured taking charge, in which the patient can be followed quickly and with more rigorous procedures, promoting an increasingly multidisciplinary healthcare approach. With greater effectiveness and savings in time and money, for the sick and the National Health Service ». Including psoriasis in the chronicity plan is one of the objectives set by the Associazione Psoriasici Italiani Amici della Fondazione Corazza (APIAFCO) which has as its mission to raise awareness, information and protect the rights of people with psoriasis: “We want to make the voice of the sick heard – concludes Valeria Corazza, president of APIAFCO -. We ask you to take part in health policy choices, aware of the contribution that associations can make to the knowledge of the real and still unsatisfied needs of the sick. Without forgetting that our NHS in reality consists of 21 regional systems and that national guidelines are needed to guarantee all patients the best care. “
Therapy depends on many variables
Psoriasis tends to prefer some parts of the body over others (elbows, knees, scalp, lower back, hands and feet), but skin lesions may not always appear in the same places. «The choice of therapy depends on the extent of the disease and the areas it involves, the impact on the quality of life and the simultaneous presence of other pathologies – explains Ketty Peris -. The treatments available today include, for the milder forms, products for “topical” use (ie to be applied directly to the skin, such as gel creams and ointments) and phototherapy. In moderate-severe forms, traditional drugs (tablets or injections under the skin) of the traditional type can be used such as methotrexate, cyclosporine or new biological drugs which are now numerous and are characterized by high efficacy and a good safety profile “.
February 15, 2022 (change February 17, 2022 | 09:44)
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