The psyche suffers from psoriasis

Psoriasis can also affect the psyche

24/10/2013

Psoriasis affects about two million people in Germany. For many people affected, the disease is not just an aesthetic flaw. The looks and sayings of the ignorant confuse and gnaw at self-esteem, because patients with psoriasis suffer from the changes in their skin. Many are ashamed of the red spots. From a medical point of view psoriasis is one of the chronic inflammatory skin diseases, but it is not contagious.

In Germany, an estimated two to three percent of the population are affected by this disease, says Thomas Rosenbach of the professional association of German dermatologists. "The most important symptom is red patches on the skin that thicken over time," he explains. "Typical silvery scales form on top of that." In extreme cases, this can even affect the whole body

Enormously fast growth of the epidermis
This malfunction of the immune system usually occurs because of a genetic predisposition. The epidermis grows very fast. Cells usually take 28 days in healthy people to move up from deeper layers of the skin. There they are then repelled as a tiny corneal shed. In people who have psoriasis, this process takes only seven days or even less.

The most common form of psoriasis (psoriasis vulgaris) is the elbow, knee and head. But also in places behind the ears, on the belly button and in the genital area, especially the gluteal fold, the disease is observed. "About half of those who develop psoriasis vulgaris also have their nails involved," explains Rosenbach. In addition to the perceived as unpleasant dandruff, the affected overcomes an itch that can go hand in hand with bleeding. "In about two-thirds of those affected, the disease begins before the age of 40, but in principle it can begin at any age, ie from childhood to adulthood," explains Sandra Philipp from the Psoriasis Center at the Charité in Berlin. "Whether, when and in what form and form the disease breaks out for the first time is unpredictable," adds Hans-Detlev Kunz from the German Psoriasis Federation. Every affected person has an individual psoriasis. For this reason, there is no uniform therapy and this makes the treatment extremely difficult.

Skin care is the first therapy step
The previous therapies are used to alleviate the symptoms and to speed up the healing process. The acute phases of the disease are to be shortened and new relapses delayed. Ideally, no further ones occur. "The first step in therapy is skin care," says Philipp. The itching can be alleviated thereby, which at the same time scratching less and thus leads to less inflammatory foci. Ointments are therefore indispensable in every therapy concept. "The gold standard today are creams that contain vitamin D and cortisone," says Rosenbach.

People with extreme psoriasis, of which one speaks when more than ten percent of the skin surface is affected, but require a different form of therapy. They can be helped with low-dose UV rays, often combined with brine baths, to enjoy a better quality of life again. This form of treatment is also known as light bathing therapy. "In addition, an internal treatment may be useful," says the dermatologist. It aims to prevent the increased growth of skin cells. New on the market are genetically engineered agents, so-called biologics, which are similar to the body's own substances. These are usually administered as an injection or infusion. "The costs of biologics are extremely high, and they can only be used if all other therapies are unsuccessful," explains Rosenbach. Long-term experience with these agents, are currently limited.

Relaxation can help
Affected suffer either chronic or in recurring episodes of psoriasis. Many patients do not want to surrender to their fate and become active in addition to the therapy, reports Philipp. However, the disease is not curable, but is positively influenced in its course. Together with the family doctor, the patient can locate the individual triggers. "A common trigger in elderly patients are beta-blockers," Rosenbach says. High blood pressure patients can often be switched to other drugs. On top of that, patients who are overweight also have a less favorable outcome. "In addition, it affects the effect of medication."

Psyche often suffers
Not to be underestimated is that the psyche plays a major role in recovery. "Often triggering experiences such as the loss of a partner or a bereavement solve the outbreak of the disease or even a boost," says Philipp. Other people's reactions to the disease are often perceived as rejecting or excluding those affected and cause stress. It is important that patients seek relaxation opportunities and thus reduce the mental stress a little. (Fr)

Image: Hamfel