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About one million people are affected by psoriasis in Poland. It is a chronic, inflammatory, autoimmune skin disease: it develops as a result of the pathological reaction of the patient’s immune system to its own antigens. It is worth emphasizing that it is not a contagious disease and therefore, as is still often believed in society, it cannot be transferred to people from the patient’s surroundings.
In the course of psoriasis, well-delimited, reddish foci with a convex, uneven surface appear on the skin, covered with white or silvery scales of excessively keratinized epidermis. The skin lesions are usually located on the straight surfaces of the joints, on the hands and feet, on the scalp and on the back, near the sacrum. However, they can even cover the entire skin of the sick person. Psoriasis also affects nails, and in severe course, joints.
The choice of treatment method is related to the advancement of the disease, the extent of the lesions and the severity of the course. Psoriasis is incurable for the time being, but treatment allows to keep the patient in remission or at least reduce the intensity of skin lesions, which improves the patients’ quality of life, increases self-esteem and allows them to return to normal life.
Treatment of psoriasis includes:
– the use of topical agents with an exfoliating effect (salicylic ointment or oil, urea or saline ointment) and reducing the proliferation of epidermal cells (tar, anthralin, retinoids, vitamin D3, corticosteroids)
– introduction of general drugs: retinoids, hydroxycarbamide, fumaric acid and disease modifying drugs, which include non-biological drugs such as methotrexate, sulfasalazine, cyclosporin A, leflunomide, or biological drugs that are monoclonal antibodies (Efalizumab, Infliximab, Adalimumab), soluble receptors for cytokines (Etanercept) or complex proteins that inhibit the activation of T lymphocytes (Alefacept)
– the use of phototherapy using UVA or UVB radiation, selective phototherapy (SUP) or photochemotherapy, when the irradiation is preceded by the administration of photosensitizers: psolaren (PUVA) or additionally retinoids (re-PUVA)
– use in severe cases of photopheresis
Factors causing relapses of skin lesions in psoriasis should also be avoided, i.e. skin injuries, stress, infections, and alcohol consumption.
med. Aleksandra Czachowska
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