Leading specialists point out what is the guideline to follow in the treatment once morest psoriasis.
Dr. Samuel Sánchez, President of the Dermatological Society of Puerto Rico; Dr. Marely Santiago, dermatologist; Dr. Luis Ortiz Espinosa, dermatologist and Medical Director of Nova Derm Puerto Rico; Dr. Paloma Alejandro, rheumatologist; Dr. Eneida de la Torre, dermatologist and research professor; Nelson González, arthritis and psoriasis patient; Dr. Anardi Agosto, President of the Puerto Rican Association of Allergists and Dr. Mariely Sierra, endocrinologist. Image: Medicine and Public Health Magazine
There is an increase in the condition of psoriasis among Puerto Ricans. Therefore, it is important that the patient attend to certain signs that might indicate that he is suffering from it and educate himself regarding the best options available to have a good quality of life.
Dr. Eneida de la Torre, dermatologist, researcher and assistant professor at the UCC, points out that the psoriasis plaque is the most common, as well as there are cases of psoriasis in drop, psoriasis reverse, pustular and erythrodermic, which is the most severe. But the psoriasis Plaque, which is the most common, is evidenced by reddened, demarcated areas on the skin that are very scaly and itchy. It is seen in areas such as the elbows, knees, and scalp, but it is also seen on the hands or feet and can progress throughout the body.
The psoriasis in gout it has smaller lesions. The psoriasis reverse can affect the armpits, feet and even genital skin. When inflamed, it can present as pustular inflammations. This can lead to mistreatment. The psoriasis erythrodermic, affects the whole body and the patient becomes acutely ill.
The psoriasis it is sometimes confused with other conditions, such as dermatitis or allergy. Dr. Luis Ortiz Espinosa, dermatologist and medical director of Nova Derm Puerto Rico, points out that the psoriasis it is a multifactorial condition; there is a genetic tendency, but the environment also influences. It is an inflammatory condition that has to do with the immune system. The most important thing is that people know that the psoriasis It is not contagious and it is not the patient’s fault, although some unhealthy habits, such as obesity, affect it.
Dr. Samuel Sánchez, president of the Dermatological Society of Puerto Rico, points out that several factors play a role, such as beta-blocker drugs, infections such as HIV, steroid treatments, which can lead to a psoriasis plaque to a more serious one, and the genetic factor.
Approach to treatments for psoriasis
Dr. Samuel Sánchez indicates that, in the beginning, the condition was treated in its topical manifestation, but this has changed and now it is managed in a more specific way. In addition, comorbidities are studied. New drugs are more effective and faster, patients suffer less. Although there is much fear of biological medicines, they provide an opportunity for patients.
Dr. Ortiz adds that topical treatments can help in a small area, but there are patients with more injuries and more needs, so they need more options. It should be insisted that the skin be hydrated, treatment with ultraviolet light or laser is also done. The steroid can also be injected into the scalp with steroid. There are traditional medicines, such as methotrexate, and new biological medicines.
The psoriasis it is treated according to severity, highlights Dr. De la Torre; In addition to steroid creams, other topical, non-steroidal medications have also been approved, because these can sometimes have adverse effects or are no longer effective.
In the case of psoriatic arthritis, Dr. Paloma Alejandro, a rheumatologist at Soto-Raíces Mindful Rheumatix and Medical Research Group, affirms that it is a systemic condition. Even if you have psoriasis, arthritis can appear 8 years later, so patients should be evaluated by a rheumatologist at least once a year. The treatment does not differ, it is the same, it includes biological and oral medicines, small molecule inhibitors and others that treat the two conditions at the same time and, if the psoriasis a little aggressively, this can prevent arthritis from appearing later.
The emotional and mental aspect of the patient must also be addressed, since they will affect the condition. It is important to consider nutrition, says Dr. Ortiz. In addition to the pharmacological medical treatment, there is a nutritional and psychological approach.
De la Torre clarifies that, although in the psoriasis there are lesions that can be seen on the skin, dermatologists will not be the only treating physicians, since there may be other comorbidities, such as diabetes, for example, and this warrants the attention of other specialists, such as endocrinologists or internists, who can do full follow up.
Finally, the patient Nelson González attests to everything that the doctors expose, since he has experienced firsthand the evolution of the treatments to manage the psoriasis and give thanks to God for the advances that are available today.
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