Interview with Doctor Toni Ionesco, dermatologist who has had a consultation dedicated to "severe psoriasis" for 20 years.
What is Psoriasis?
Psoriasis is a chronic inflammatory disease of the skin which affects more than 7.5 million people (or 3% of the US adult population) aged 20 years or older in the US. Psoriasis develops in genetically predisposed people (a family history of psoriasis and changes shown by genetic studies are systematically found). These predisposed people are exposed to triggering factors of the disease such as: stress, certain drugs such as beta-blockers, lithium salts and others.
How does the disease appear? What areas of the body can be affected?
Redness and scaling (in the form of small or large plaques, more or less thick) appear on areas of the skin subjected to trauma and friction such as the elbows and knees, but the plaques can affect all areas of the body, the scalp, or any skin folds. It should be noted that psoriasis is not a contagious disease.
Does it particularly affect a certain group of people (age, skin type, gender, origins, etc.)?
Psoriasis can start at any age (from infants to the elderly), with peak frequencies being between 16 and 22 years old and between 57 and 60 years old.
Can this disease be cured?
As it is a disease with a genetic predisposition, we have to accept the idea that there is no cure for psoriasis, but the good news is that we now have many very effective treatments for psoriasis, most of them orally or even more injectable drugs.
What treatments are offered?
For a very long time, local treatments have been available to treat psoriasis plaques that do not extend over too large areas: creams, lotions and ointments based on cortisone, vitamin D or a combination of the 2 substances. For the largest, more severe forms of psoriasis, local treatment is not enough and it is necessary to switch to treatment either by ultraviolet radiation (in dermatology departments or surgeries – treatments in medical cabins which emit UVA or UVB rays perfectly dosed, these are not tanning booths) or it is necessary to switch to “conventional” treatments generally such as methotrexate (in tablets or injectable) or ciclosporin – which are very effective treatments but which require close monitoring by the prescribing dermatologist (periodic blood tests, etc.). In the event of failure of one or more "conventional" treatments, more recent injectable treatments, called "biotherapies", can be prescribed.
Can a crisis be prevented? How to relieve her once she is there?
Psoriasis progresses through “flare ups” (triggers) with periods of worsening red plaques and scaling, and calmer periods with fewer rashes. Flare ups must be treated with local medications - associated in the case of very large areas affected - with systemic treatments. Do not forget to associate with any type of local and or general treatment - emollients well tolerated and specially designed and tested to soothe and reduce the itching or discomfort of psoriatic plaques.
What is the impact of the disease on the quality of life?
The quality of life of people suffering from psoriasis is most often very impacted (given that the plaques generally affect very visible areas of the body, the hands, the feet), which is why we urge people who notice the appearance of psoriasis plaques to consult their dermatologist as soon as possible. They can prescribe the most suitable treatment and quickly improve the quality of their life.