World Psoriasis Day I Psoriasis Treatment: Home remedies like onion and garlic extracts can cause an irritant reaction – Dr Tarun Narang


Psoriasis (Representative Photo – Pixabay)

World Psoriasis Day is scheduled for October 29 each year to empower and educate people living with this disease and their caregivers. Doctor Tarun Narang, Associate Professor, Department of Dermatology, Venereology and Leprology, PGIMER Chandigarh shares his point of view with Biplob Ghosal from on psoriasis, which he called a chronic non-infectious treatable skin disease.

Question: What is the average time to diagnosis for patients with psoriasis?

Dr Narang: The diagnosis of psoriasis is clinical, it is generally made at the first visit, by a “dermatologist”. However, it can sometimes be difficult for general practitioners or other licensed physicians with limited exposure to dermatology to diagnose psoriasis early, which can sometimes delay the correct diagnosis and management of the disease.

We have seen patients treated for eczema or fungal infection for months until they see dermatologists and a correct diagnosis of psoriasis is made. Additionally, patients can sometimes try to diagnose their condition through a Google search, which further adds unnecessary delays and treatment before the correct diagnosis is made.

Question: What do you think of people who opt for home remedies instead of seeing a dermatologist for their treatment?

Dr Narang: With the use of home remedies, the possibility of a worsening of the existing condition is the main concern and sometimes they may not be effective and only provide temporary relief. The practice of applying oil to skin lesions and sunbathing, for example, is beneficial for psoriasis. However, personal practices such as applying home remedies such as onion and garlic extracts and certain plant leaf pastes can cause an irritating reaction or even scarring on the skin and can cause a flare-up of psoriasis. . Therefore, patients are advised to regularly consult dermatologists for their skin condition and, if necessary, seek advice on the use of home remedies if desired.

Question: What treatment options would you recommend for treating psoriasis? Do you see biologic therapy as an effective treatment option for moderate to severe psoriasis?

Dr Narang: The treatment options are varied and numerous for psoriasis. First, we need to observe the extent (severity) and type of this condition. Sometimes treatment can vary depending on the different parts of the body where the disease has occurred. For example, the treatment options for scalp psoriasis are different from palmoplantar psoriasis (affects the skin of the palms and soles of the feet). All of these factors are therefore taken into consideration before deciding on the appropriate treatment options for a given patient.

Usually, for limited disease, topical treatment with coal tar, topical corticosteroids, calcipotriol and / or keratolytic agents as well as moisturizers may suffice. Always keep in mind that systemic steroids should be avoided in patients with psoriasis.

Treatments with biologics for effective treatment of moderate to severe psoriasis are available in India and are used in patients with severe disease or those with associated arthritis or when conventional systemic agents cannot be used. used because of co-morbidities or side effects.

However, the use of biologics is generally limited by cost limits, as the drugs are generally required for long periods of time to maintain the therapeutic effect for the long term treatment process associated with this disease. Therefore, not everyone is financially able to continue treatment with biological therapy. Therefore, it is the call of the hour for insurance providers to secure appropriate health coverage for patients undergoing treatment with biologics, especially for those in need.

Question: What advice will you give to patients who stop their treatment due to the current pandemic?

Dr Narang: Given the ongoing pandemic, patients may fear using drugs due to fear of immunosuppression and the increased risk of contracting COVID-19. However, it is in the best interest of patients that they consult their treating dermatologists so that the real risks that their current medications may pose can be discussed and that alternative medications can be prescribed if they deem it appropriate. The risks of flare-ups from abruptly stopping medications can lead to co-morbidities, so patients should consult their treating dermatologist before making any treatment decisions.

Question: Is it now a safer time for patients who visit clinics / hospitals for consultation?

Dr Narang: With the global COVID-19 pandemic still ongoing, it is advisable to limit visits to clinics and hospitals until absolutely necessary. Most centers offer reliable teleconsultation services that deal with minor changes in disease severity, and medication change can be advised accordingly. The requirement for a direct visit or admission may be advised following teleconsultation in severe illness, especially with systemic symptoms, if considered, by the attending physician. All precautions for the prevention of COVID should then be taken, including proper wearing of a mask, observing hand hygiene and maintaining a social / physical distance when visiting a clinic / a hospital.

Question: Do you see patients with psoriasis who might show symptoms of depression after living with this disease for a while?

Dr Narang: Yes, we see patients with psoriasis who develop depression as a result of the disease. In a study we recently conducted, it was found that depression was the most common psychological comorbidity in our patients with psoriasis, which was around 30%.

Psoriatic lesions on exposed areas of the skin cause the feeling of being unattractive and frustration occurs. As a result, patients tend to isolate themselves socially and begin to be alone, which makes them depressed. Psoriasis affects the social, personal and sexual life of patients, causing psychological tension.

Myths that psoriasis is a contagious disease stigmatize and exclude patients from schools, workplaces and social gatherings. These problems are particularly troublesome in young patients. Additionally, the chronic inflammation occurring in psoriasis has also been implicated in the pathogenesis of depression. Therefore, it is necessary that all patients with psoriasis are screened for depression and counseled regarding the nature and course of the disease. If someone has feelings of hopelessness, anxiety, loss of interest, sleep or appetite, they should discuss this with their treating dermatologist.

Ques: Do you have another comment you would like us to highlight to support awareness among people living with moderate to severe psoriasis?

Dr Narang: It is important for people to realize that psoriasis is a chronic, non-infectious skin disease that can be treated. Stress, obesity, alcohol, and smoking can make the disease worse, as can some medications and infections. Therefore, patients should be encouraged to exercise, control their weight, limit their alcohol intake, and quit smoking. All patients should consult a dermatologist and avoid self-medication. Family and community support is needed to minimize stigma and improve patient mental health.

Disclaimer: The tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or healthcare professional if you have specific questions about a medical problem.

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