Psoriasis is a dry scaly skin disorder. Normally skin cells take about 28 days to replace themselves; however, this takes only 2-6 days in psoriasis patients. This rapid acceleration of usual skin cells replacement process is caused by the immune system mistakenly “switched on”. This results in rapid accumulation of skin cells that flake off constantly. It is estimated that 1-2% of Singapore population have psoriasis.
Psoriasis appears as salmon red and scaly patches. Typically, it occurs at the scalp, hairline, elbows, knees and lower back. Psoriasis can sometimes affect the nails and joints. Very often, the nail plates are deformed with pitting, yellowish staining, thickened and disfigured nail plates. There can also be joint pain with swelling on the fingers, knees and ankles in many patients.
The cause of psoriasis is partly genetic and partly environmental.
Very often, there is a positive family history in patient with psoriasis. There is an increase risk of the children getting the psoriasis if the parents or one of the parents has psoriasis. Environmental factors like physical or chemical injury to the skin, throat infection, reaction to certain drugs, hormonal changes, climate factors, mental and emotional stress can contribute to the onset and perpetration of psoriasis.
Psoriasis is an incurable disease. Most patients will have psoriasis for life and only a very small proportion of patients go into remission completely.
Psoriasis is neither infectious nor contagious. It cannot be passed on to other people.
Every patient has their own preference and each patient will respond to the treatment differently; hence, psoriasis treatment approach is highly individualized. During your consultation with Dr Wong, he will evaluate your condition and recommend suitable treatment tailored to the severity of your psoriasis.
A special combination topical therapy is what Dr Wong prefers these days as it enables a quicker, more complete response with minimal or no local irritation to the skin. Separate scalp solution is often prescribed for treating psoriasis on the scalp.
Useful for patient with more extensive psoriatic plaques and for patient who does not respond well to topical treatment. Phototherapy uses ultraviolet light to slow down the division of cells in the skin and is usually administered 2 to 3 times a week. When the skin is clear of psoriasis, treatment is maintained and given less frequently.
Oral medications are usually reserved for patient with more severe disease and for patient who does not respond well to topical treatment and phototherapy. Drugs like Methotrexate, Cyclosporin A and Acitretin are very effective in the control for psoriasis; however, all these drugs have potential side effects. Blood tests need to be done regularly to monitor the drug effect on blood count, kidney and liver function.
This is a new class of drugs that come from psoriasis research. They are given as injections and they are very effective in controlling psoriasis. Their main advantage is the absence of organ damage to kidney, liver and the ease and convenience of receiving the treatment. Their main disadvantage is that the treatment is costly. All pros and cons will be discussed with you before Dr Wong starts you on Biologic injection treatment.