2.5 to 3 percent of the world’s population has psoriasis

Psoriasis is an autoimmune disease with many forms

A significant percentage of people with psoriasis skin disease suffer from itchy, scaly patches almost continuously. It doesn’t matter how much ointment they lubricate. Not necessary, says dermatologist Bing Thio of Erasmus MC. There are several therapies nowadays that can help almost any patient to have fair skin.

Choose fair skin, was the motto of World Psoriasis Day on 29 October. In 2022 alone, dermatologists can prescribe 12 different types of biologic injections to people with severe psoriasis. For people with moderate psoriasis, an arsenal consists of tablets and phototherapy.

Miserable
Sure, biologics are expensive drugs, but living with psoriasis is unhappy for many patients, Thio knows. ‘Living with scaly patches on the skin creates a negative self-image. It makes people miserable. Even people with psoriasis who said they weren’t bothered by their spots felt a boost when they got rid of them. They get more energy, they feel like they’re in love with life, “he says.

Psoriasis is an autoimmune disease of many forms. About 400,000 Dutch people suffer from it. One has stitches on the elbows, the other is from head to toe. In still another, the spots only form in winter. How it looks also depends on ethnicity. The skin of Asian people with psoriasis shows inflamed crimson patches, while the patches of Caucasian people are more pink.

Genes
Psoriasis is, like other autoimmune diseases, in the genes. Currently 65 are known, but scientists suspect there are many more. ‘The disease cannot be cured by means of that genetic component, because so far we have not been able to turn off those genes. Th1 and Th17 T helper cells are involved. You can think of them as the generals who command the immune system to attack the skin. That attack creates the wobbly points. ‘

For decades, there wasn’t much that could be done about psoriasis other than ointments. New drugs called biologics have brought about the change. ‘With these injections you deactivate only the attacking proteins that make the generals: these are the proteins TNF, Interleukin-17 and -23.

Arthritis
The new drugs work well, Thio knows. Almost all of them are symptom-free over time. He thinks it’s important. Not only because the spots have a strong impact on the quality of life, but also because 1 in 5 patients develop arthritic psoriasis over time, in which the joints also become inflamed. “There are side effects,” he says. “15-20% are more likely to suffer from respiratory infections, especially during the flu season. But those complaints are manageable. ‘

2.5 to 3 percent of the world’s population has psoriasis. Living in a big city doesn’t help. Recent research shows that people living in large cities are more prone to psoriasis. “The genes involved in psoriasis are, so to speak, activated more often in large cities, presumably due to factors more common in the city: air and light pollution, stress. But something can be done about complaints. We want to attract the ‘focus on this with World Psoriasis Day.’

The expensive biologic therapies mentioned above can only be prescribed in hospitals. Psoriasis patients who have been treated by their GP but haven’t cleared up their complaints can discuss with their GP whether they can get a referral to a dermatologist.