The comorbidity of psoriasis spreads all over the body. Latest guidelines from the Dermatology Association: Toward the goal of "clearing" the lesions
Is there an outbreak of psoriasis in cold weather? Medical: Achieve optimal treatment goals as early as possible
The temperature drops sharply in autumn and winter, and temperature stimulation can easily worsen the lesions of skin diseases. Dr. Huang Yuhui, Medical Director and Spokesperson of Taiwan Dermatology Department and Department of Dermatology, Taipei Linkou Chang Gung Memorial Hospital, pointed out that as the weather becomes colder, seborrheic dermatitis, atopic dermatitis and psoriasis worsen frequently, especially psoriasis is not just a skin problem. , and is also related to comorbidities such as psoriatic arthritis, irisitis, cardiovascular disease, and inflammatory bowel disease.
Psoriasis is a chronic inflammatory skin disease caused by immunity. Common symptoms of patients include thickening of the skin, desquamation of the lesions, and erythema on the skin. It is not only related to genetic factors, but also traumatic stimulation and climate change are also risk factors. The Taiwan Dermatological Association announced the 2023 psoriasis treatment guidelines and recommended that psoriasis patients should have “minimum disease activity” (BSA <1% or PASI greater than 90, IGA 0/1 or PASI absolute score less than or equal to 1) as the best option Treatment goals.
According to statistics, more than 1.25 million people worldwide suffer from psoriasis, and the incidence rate is increasing year by year. Professor Zhang Yunting of the Dermatology Department of Taipei Veterans General Hospital, said that there are about 100,000 psoriasis patients in Taiwan, of which 80- 90% belong to the most common form of “plaque psoriasis”, which mostly occurs between the ages of 18-39 and 50-69. The most common skin features of plaque psoriasis include: well-defined erythematous areas and sclerotic plaques with scaling, which occur behind the ears, face, trunk, elbows, genitals, nails, knees, The ratio of hands to soles is the highest.
“There are now very good treatments for psoriasis, including oral drugs, topical ointments, light therapy, and 9 biological agents in 4 categories. These biological agents are advanced monoclonal antibody drugs. If the lesion area still exceeds 3 %, or if there are still obvious lesions on the scalp, eyes, nails, etc., you can also evaluate “parallel conversion” to another biological agent to achieve the best treatment goal as soon as possible! "
Professor Zhang Yunting pointed out that about 20-30% of patients with psoriasis in Taiwan have symptoms of “moderate to severe” or above. Those who do not have psoriatic arthritis and have mild psoriasis can use topical drugs, local light or oral small molecule markers. Target drugs; for moderate to severe psoriasis, systemic treatments including: biological agents, oral drugs, and systemic phototherapy are given priority. Biological agents can reduce the secretion of cytokines such as TNF-a, IL-12, and IL-17 to achieve the effect of treating psoriasis.
Dilemma in treating moderate to severe psoriasis? Biological agents help move towards “zero”
“The two major assessment indicators of psoriasis severity are the body surface area (BSA) assessment method and the psoriasis area and severity index (PASI). In terms of body surface area, the total number of psoriasis lesions reaches 10 Psoriasis that is larger than the size of your palm is considered moderate to severe. In the past, the treatment goal was to improve the lesions by 50-75%. Nowadays, there are various advanced treatments such as biological agents. We look forward to helping more patients with psoriasis move towards the goal of “clearing” the disease. go ahead!”
Dr. Huang Yuhui said that the current best treatment goals for psoriasis include controlling BSA to less than 3% for 3 months, maintaining BSA to less than 1% for 6 months, and improving 90%-100% of lesions (PASI 90 or PASI 100), however, clinically, patients with moderate to severe psoriasis often interrupt treatment due to problems such as ineffective treatment effects, drug side effects, difficulty in using drugs, and difficulty in obtaining drugs. Patients with psoriasis are urged to actively discuss medical decisions with their doctors and understand their PASI index.
Although psoriasis can be cured, it cannot be eradicated. If patients have questions about the effectiveness of treatment, they must take the initiative to discuss it with their doctor. Dr. Huang Yuhui pointed out that psoriasis patients in Taiwan are more concerned about “safety” and believe that the treatment of psoriasis requires long-term care. In fact, through good and effective treatment, there is a chance to achieve the ideal treatment goal within the golden time. In addition, women who are pregnant or preparing for pregnancy face more difficulties in choosing treatment drugs. It is recommended to consult a specialist as soon as possible to find a treatment strategy that can not only stabilize psoriasis control but also ensure a safe pregnancy.
Dr. Huang Yuhui emphasized that after entering the digital age, advertising products that illegally use doctors’ images to claim efficacy are rampant. He reminded the public and the psoriasis community not to buy drugs from unknown sources through online advertisements. Spending a lot of money to buy ineffective products not only delays During the prime treatment time, bad products are more likely to worsen the course of the disease.
Professor Zhang Yunting reminded that in addition to receiving proper treatment for people with psoriasis, the five major daily health care priorities include weight loss, abstinence from alcohol and tobacco, proper moisturizing, stress relief, and communication with doctors and patients. Patients are urged to make good use of the auxiliary tools for medical and disease consultation, do their homework before seeing a doctor, and conduct efficient medical consultation, which is more conducive to the stable control of the disease.
