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Dr Mark Goodfield says:
‘Psoriasis is a complicated disorder, it is genetically determined but in a rather complex way. There’s no simple pattern of inheritance, but within a family you will normally find different family members who are affected.’
Mark says: ‘The disease is very easily recognized and particularly in these common areas: elbows, knees, and scalps. The main features of the disease are its redness and its scaliness. Skin disease in general has a much bigger impact on the quality of life then people realize. And psoriasis is one of these conditions that is right up there at the top of disease impact, partly because it’s so visible. It isn’t catching, so although there may be other members of your family that have got it. You can’t give it to them or give it to partners or to friends.’
‘The treatment for psoriasis as for any skin disease, starts with simple topical treatments. There are also quite old-fashioned things like tar preparations which are ok, a bit messy and smelly, but they do have a role in treating psoriasis.
‘The next conventional thing to do when patients come having taken topical treatment is to give them ultra-violet light therapy. The big risk associated with ultra-violet treatments is we undoubtedly increase the risk of the patient getting skin cancer in their lifetime. And the more ultra-violet we give, just like the more sun-light you get, the greater the risk of skin cancer. If you don’t do well with UV light, then we move to a tablet treatment quite quickly. By not doing well, I mean not responding, because almost everybody responds when we give them treatment, but it can relapse once the treatment stops.
‘Somewhere between 10% – 25% of all patients with psoriasis will have significant joint problems directly related to the psoriasis. Now a whole new group of drugs are available for the treatment of psoriasis and artritis. These are called biologics – they are broadly antibodies, directed at the chemicals or the cells that make the inflammation happen in the skin or in the joints. These are given either as an infusion drip or an injection. The injection treatments are given once or twice a week and the drips are given at intervals of anywhere between 4 and 8 weeks, depending on how bad you are and how well they work.
‘Psoriasis is so unpredictable that quite often it will just resolve itself. It will go away spontaneously and that does happen to a proportion of patients.
‘Accepting that psoriasis is not a disease you want to get, but if you have got it, we now have a lot of treatments for you which wasn’t the case even 10 or 15 years ago.’
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