Why psoriasis is alarming disease ?

Psoriasis is a common chronic inflammatory disorder of the skin frequently characterized by relapsing thick scaling plaques, with or without nail and joint involvement. While not life threatening, psoriasis may cause substantial disability subsequent to both physical discomfort (e.g. pruritus, arthralgias, etc.) as well as psychosocial harm. Impaired quality of life, and high direct and indirect costs. New therapies have been developed during the last decade that have been increasingly effective, but with potentially significant adverse side effects and higher costs, which puts patients at risk and calls into question the sustainability of health systems.

What is the prevalence of Psoriasis?

How comorbidities affect life?

Moderate and severe forms associated with significant comorbidity, Psoriasis is frequently associated with several comorbidities (e.g., cardiovascular disease, diabetes, obesity, and the metabolic syndrome), including psychological conditions (e.g., depression and anxiety) which are frequently associated with worse health-related quality of life and adherence to treatment regimens.

How psoriasis develops ?

In psoriasis, the life cycle of your skin cells greatly accelerates, leading to a build up of dead cells on the surface of the epidermis.

What causes Psoriasis ?

psoriasis was viewed as primarily a disease of hyperproliferation; however, it is now known that psoriasis is a complex immune-mediated disease in which T lymphocytes cells play a central role.

How Psoriasis look like?

Plaque psoriasis

Scalp psoriasis

Inverse psoriasis    

What are the types of Psoriasis ?

Plaque Psoriasis

Scalp psoriasis

Inverse Psoriasis

Nail psoriasis

Pustular psoriasis

Erythrodermic psoriasis

What are the comorbidity of Psoriasis really affect quality of life ?

Psoriatic arthritis

Psoriatic arthritis is an inflammatory seronegative spondyloarthropathy that occurs in association with psoriasis. Estimates of the proportion of patients with psoriasis who develop psoriatic arthritis range from 7 to 42 percent. Psoriatic arthritis is characterized by stiffness, pain, swelling, and tenderness of the joints.

●Obesity

Psoriasis and obesity have inflammation in common. Inflammation is the root of all health problems and obesity increases inflammation. Obese people, carrying extra body fat are prone to inflammatory disorders, including psoriasis and psoriasis arthritis. It doesn’t mean that obesity is a definite cause for psoriasis, but, obesity can be one of the reasons.

●Metabolic syndrome

psoriasis were more likely to have metabolic syndrome than individuals in the general population. Population-based studies have found increased rates of components of the metabolic syndrome (hyperlipidemia, hypertension, and diabetes) in children with psoriasis

●Cardiovascular, cerebrovascular, and peripheral vascular disease

Researchers are still working to understand exactly why and how people with psoriasis tend to have a higher risk of cardiovascular diseases. Currently, they think that the type of inflammation that causes the production of excess skin cells in people with psoriasis is also related to the process of atherosclerosis. Some psoriasis medications can also cause cardiovascular symptoms, such as high blood pressure or high cholesterol levels. The good news is effectively treating psoriasis can reduce your risk of heart attack and stroke.

●Malignancy

Multiple factors may contribute to an increased rate of malignancy in patients with psoriasis, including the effects of immunosuppressive or immunomodulatory therapies and the presence of a chronic inflammatory state.

●Autoimmune diseases

Compared with the general population, autoimmune disease may be more likely to occur in individuals with psoriasis.

An increased risk for multiple autoimmune diseases was detected, with the greatest risk increase observed for alopecia areata, followed by celiac disease, systemic sclerosis, Crohn's disease, vitiligo, and other disorders.

Chronic kidney disease

Patients with psoriasis may have an increased risk for chronic kidney disease.

●Non alcoholic fatty liver disease

Psoriasis may also be associated with greater severity of NAFLD. A study in which NAFLD was detected in 59 percent of 142 patients with psoriasis found that patients with psoriasis.

●Psychosocial effects

Psoriasis can have detrimental effects on the quality of life of adults and children. Elevated rates of various psychopathologies, including poor self-esteem, sexual dysfunction, anxiety, depression, and suicidal ideation have been reported in patients with psoriasis. Occupational success may also be inhibited by psoriasis. Lower rates of employment and decreased work productivity have been linked to psoriasis

Is psoriasis a contagious disease ?

Psoriasis is not a contagious disease

What is the target of treatment ?

Psoriasis is not a curable disease; it is a controllable disease.

What are the available treatment in Bangladesh.

Psoriasis treatments reduce inflammation and clear the skin. Treatments can be divided into three main types: topical treatments, light therapy and systemic medications.

1. Topical psoriasis treatments include:

Topical corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They reduce inflammation and relieve itching and may be used with other treatments. Mild corticosteroid ointments are usually recommended for sensitive areas, such as your face or skin folds, and for treating widespread patches of damaged skin.

Vitamin D analogues. These synthetic forms of vitamin D slow skin cell growth. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that treats mild to moderate psoriasis along with other treatments.

Anthralin. This medication helps slow skin cell growth. Anthralin (Dritho-Scalp) can also remove scales and make skin smoother. But anthralin can irritate skin, and it stains almost anything it touches. It's usually applied for a short time and then washed off.

Topical retinoids. These are vitamin A derivatives that may decrease inflammation. The most common side effect is skin irritation. These medications may also increase sensitivity to sunlight, so while using the medication apply sunscreen before going outdoors.

Calcineurin inhibitors. reduce inflammation and plaque build-up. They may be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.

Salicylic acid.  salicylic acid promotes sloughing of dead skin cells and reduces scaling. Sometimes it's combined with other medications, such as topical corticosteroids or coal tar, to increase its effectiveness.

Coal tar. Derived from coal, coal tar reduces scaling, itching and inflammation. Coal tar can irritate the skin. It's also messy, stains clothing and bedding, and has a strong odor.

Coal tar is available in over-the-counter shampoos, creams and oils. It's also available in higher concentrations by prescription. This treatment isn't recommended for women who are pregnant or breast-feeding.

Moisturizers. Moisturizing creams alone won't heal psoriasis, but they can reduce itching, scaling and dryness. Moisturizers in an ointment base are usually more effective than are lighter creams and lotions. Apply immediately after a bath or shower to lock in moisture.

2. Light therapy (phototherapy)

Sunlight. Exposure to ultraviolet (UV) rays in sunlight or artificial light slows skin cell turnover and reduces scaling and inflammation. Brief, daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms and cause skin damage. Before beginning a sunlight regimen, ask your doctor about the safest way to use natural sunlight for psoriasis treatment.

UVB phototherapy. Controlled doses of UVB light from an artificial light source may improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single patches, widespread psoriasis and psoriasis that resists topical treatments. Short-term side effects may include redness, itching and dry skin. Using a moisturizer may help decrease these side effects.

Narrow band UVB phototherapy. A newer type of psoriasis treatment, narrow band UVB phototherapy may be more effective than broadband UVB treatment. It's usually administered two or three times a week until the skin improves, and then maintenance may require only weekly sessions. Narrow band UVB phototherapy may cause more-severe and longer lasting burns, however.

Psoralen plus ultraviolet A (PUVA). This form of photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more responsive to UVA exposure.

Excimer laser. This form of light therapy, used for mild to moderate psoriasis, treats only the involved skin without harming healthy skin.

3. Oral or injected medications

If you have severe psoriasis or it's resistant to other types of treatment, your doctor may prescribe oral or injected drugs. This is known as systemic treatment. Because of severe side effects, some of these medications are used for only brief periods and may be alternated with other forms of treatment.

Retinoids. Related to vitamin A, this group of drugs may help if you have severe psoriasis that doesn't respond to other therapies. Side effects may include lip inflammation and hair loss. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication.

Methotrexate. Taken orally, methotrexate (Rheumatrex) helps psoriasis by decreasing the production of skin cells and suppressing inflammation. It may also slow the progression of psoriatic arthritis in some people. Methotrexate is generally well-tolerated in low doses but may cause upset stomach, loss of appetite and fatigue. When used for long periods, it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets.

Cyclosporine. Cyclosporine  suppresses the immune system and is similar to methotrexate in effectiveness, but can only be taken short-term. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. Cyclosporine also makes you more susceptible to kidney problems and high blood pressure — the risk increases with higher dosages and long-term therapy.

4. Newer drugs:

Drugs that alter the immune system (biologics). Several of these drugs are approved for the treatment of moderate to severe psoriasis. They include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz).

Most of these drugs are given by injection (apremilast is oral) and are usually used for people who have failed to respond to traditional therapy or who have associated psoriatic arthritis. Biologics must be used with caution because they have strong effects on the immune system and may permit life-threatening infections. In particular, people taking these treatments must be screened for tuberculosis.

Why psoriasis awareness club formed in Bangladesh ?

Now we all know about Psoriasis and the huge number of people this disease affects. It is both a social and economic burden currently affecting nearly 125 million people worldwide.

Psoriasis Awareness Club is the first of its kind club In Bangladesh bringing together Doctors, Patients and Social Workers together in a common quest.

What is our mission? Well Our mission is to improve the quality of life of people who have psoriasis and psoriatic arthritis. Through education and advocacy, we promote awareness and understanding, ensure access to treatment and support research that will lead to effective management and, ultimately, a control.

Now I have been asked why I have taking a initiative for such a club. The reason is simple. Over my long career and working closely with Psorisas patients I have found these 5 reasons to speak out about this disease.

1.Lack of public awareness and misperceptions of the disease

2.Lack of medical professional  knowledge and recognition of psoriasis

3.Lack of access to treatment(s)

4.No national statistics for how many people suffer with psoriasis in our country

5.There must be research towards a cure!

And to tackle these difficulties we have made 5 objectives we want to achieve

1.To provide support, encouragement, and a sense of community to psoriasis patients

2. To be the voice of psoriasis patients – to the medical community, to the government, to officials making decisions about healthcare and access to treatment

3. To be an authority on the disease

4. To create awareness that psoriasis is a serious, noncommunicable, systemic disease and finally

5. If we don’t speak for those suffering with psoriasis, who will?

Psoriasis Awareness Club hopes to usher in new revolution and new beginning for Psoriasis patients. Together with your help I truly believe this club can be the focal point of all the changes.

Psoriasis awareness club of Bangladesh is a non-profitable organization  Doctors, Patients and Social Workers together works in a common quest  to improve the quality of life of people who have psoriasis and psoriatic arthritis.

 Psoriasis Awareness Club hopes to usher in new revolution and new beginning for Psoriasis patients. Together with your help I truly believe this club can be the focal point of all the changes.

Recently this club is recognised internationally and affiated with International federation of psoriasis association.