On World Psoriasis Day 2022, Dr Ratna Devi, CEO and Co-founder, DakshamA Health and Tamanna Sachdeva, Manger-projects, DakshamA Health emphasises that patients with psoriasis can overcome stigma and discrimination if society becomes more inclusive through large-scale awareness campaigns
A non-communicable, inflammatory skin disease, psoriasis, affects 2-3 per cent of the world’s population, or roughly 125 million people[1]. The prevalence of psoriasis in India among adults varies from 0.44 to 2.8 per cent[2]. It is distinguished by an unpredictable course of symptoms, a wide range of extrinsic triggers, and severe comorbidities, including arthritis, metabolic syndrome, cardiovascular disease, inflammatory bowel disease, and depression.
The World Health Assembly recognized psoriasis as a critical non-communicable disease in 2014 and passed a resolution to improve the lives of people living with this condition1. That in turn brought the public health impact of psoriasis into focus. To combat the rising prevalence of psoriasis, WHO suggested strategies and solutions that policy makers and patient organisations must adopt. However, there is still a significant gap that needs to be filled, and much more work needs to be done.
With a vision of achieving Universal Health coverage, ICMR has developed “Standard Treatment Workflows” for common and serious diseases. It includes therapies and few available treatments for psoriasis. However, a holistic approach for treating the disease is still unavailable. The guidelines are fuzzy when addressing things like epidemiology, referral mechanisms, alternative therapies, the current burden, dos and don’ts, and specific treatments. There is a dearth of data on Indian psoriasis patients, genetics, epidemiology, disease kinds, associations and severity. The majority of the data on the prevalence of psoriasis in India comes from hospital-based studies rather than well-defined, large population-based studies. There is still no cure for this disease, and treatment is limited to symptom management. Studies on risk factors are rarely conducted, which would aid in the identification of preventative strategies that are critical for chronic non-communicable illnesses with no definite cure.
Psoriasis is not “just” a skin condition. It is said to be a complex disease with multiple impacts for patients’ lives. They are not only managing their symptoms, but also facing several problems with their daily lives. Being stigmatised and discriminated against, as well as feeling lonely and isolated, makes them less productive in their lives. This, in turn, has an impact on their mental health. This also affects their daily routines, studies, interpersonal relationships and jobs. The government formulary has limited medicines listed and most often patients have to pay out of pocket for their treatment, leaving them financially weak and drained. Due to this, they have to either leave their medications or go with some alternative therapies to manage their conditions. Lack of awareness and information leaves patients and caregivers clueless, making them feel burdened and losing hope in their lives. Treating psoriasis patients necessitates not only treating skin lesions and joint involvement, but also identifying and managing common comorbidities, such as cardiovascular and metabolic disorders, as well as psychiatric conditions, which may already exist or develop.
A patient-centered strategy with an equal voice for individuals living with the condition has been recognised as the best approach globally to disease management. Treatments can be made more accessible by including them on the national list of essential medicines and incorporating into national insurance policies. Patients with psoriasis can overcome stigma and discrimination if society becomes more inclusive through large-scale awareness campaigns. Caregivers and patient support groups can provide much-needed comfort to those who are impacted. This Psoriasis Day, let us come together to strengthen the patient voice so that their voices can be heard, and they can live a better, more dignified life.
References:
[1] https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf.psoriasis?sequence=1
[2]https://pubmed.ncbi.nlm.nih.gov/27990381/#:~:text=Abstract,with%20a%20slight%20male%20preponderance.
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