Dr. Vesel Kantarjiev: Psoriasis also affects the joints

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Dr. Vesel Kantarjiev: Psoriasis also affects the joints
Dr. Vesel Kantarjiev: Psoriasis also affects the joints

Every year at the end of October we celebrate the World Day of people with the skin disease psoriasis and its complications. Although there is no register of patients, it is believed that in our country, no less than 150,000 people suffer from psoriasis. For comparison, 30 years ago the number of patients was around 18,000, patient organizations reported

However, psoriasis is not contagious, remind dermatologists. It is characterized by red spots that become covered with scales. Sometimes it involves the whole body and can appear at any age, but in most cases it happens before the age of 40.

“A major misconception among our society is that psoriasis is a skin disease. This is not the case as the disease affects the whole organism and leads to complications such as diabetes mellitus, cardiovascular problems, arthritis as well as depression. According to world studies, the psyche of patients with psoriasis is affected as much as the psyche of people with oncological and cardiovascular diseases", commented Dr. Vesel Kantarjiev, head of the Dermatology, Venereology and Allergology Clinic of the Academy of Medical Sciences, for "Doctor" Sofia.

Dr. Kantarjiev, since 2 years at the Academy of Medical Sciences you have been organizing campaigns dedicated to psoriasis. What happens to the people who trust you?

- The Dermatology Clinic of the Academy of Medical Sciences is one of the leading centers for the fight against psoriasis. There are over 150,000 Bulgarians with psoriasis, and their diagnosis often becomes a punishment not only for them, but also for their relatives. Personal relationships suffer a lot, the percentage of depressive states in these patients is also extremely high. Therefore, our goal is to increase their quality of life.

During the last free examinations, nearly 400 patients received consultations. All are charted and an individual treatment plan is drawn up for each. Within the framework of the campaign, patients had the opportunity to familiarize themselves with all the modern methods of treating the disease applied in the clinic, which is a national center for the fight against psoriasis.

We still can't say what provoked him. The reasons for the appearance of the disease are different, the main one being the way of life. Most often, psoriasis develops as a result of emotional stress, but sometimes - also after the use of certain medications. Some antibiotics can also trigger it. Psoriasis has many different forms - it can be asymptomatic, and it is possible to involve large areas of the skin. The bad thing is that the risk of cardiovascular accidents jumps sharply in patients - up to 40%, as well as of diabetes - in 30-40 percent of patients.

The disease proceeds individually, there are usually episodes of exacerbation. It should be known that apart from the skin, psoriasis can affect the joints and internal organs. Therefore, our recommendation is not to resort to self-medication, but to seek specialized medical assistance.

Is the disease contagious?

- Believe it or not, psoriasis is not contagious. The disease is not contagious, it is not transmitted from person to person. The reason for its appearance lies in the human genes. However, not everyone who is predisposed to developing psoriasis will develop the disease. The disease can be triggered by an infection, a stressful experience, or certain medications.

There are approximately 125 million psoriasis sufferers in the world - 2 to 3% of the population. In Bulgaria, there is no registry for patients with psoriasis, but when comparing the data from the world practice, it can be considered that about 2% of Bulgarians suffer from the disease. This means that no fewer than 150,000 people are affected. Unfortunately, between 10 and 15% of new cases are children under 10.

The disease is unlocked at a relatively young age - on average around 28 years old. The unpleasant marks on the skin often make others distance themselves from those suffering from psoriasis, but keep in mind that you cannot get infected with psoriasis in any way. The problem is more of an aesthetic one.

What causes it?

- Research shows that most cases of psoriasis are hereditary due to the disease running in families of those affected. It is believed that certain hereditary genes may be associated with psoriasis, but the exact pattern by which this occurs has not yet been discovered.

Very often infections are involved in the appearance of psoriasis symptoms. Bacteria, especially streptococci, are the most common pathogens and are associated with punctate psoriasis. Infection with the human immunodeficiency virus - HIV, although it is not a direct cause of psoriasis, has been proven to increase the likelihood of deterioration of the condition of an already manifested disease. Psychological stress can make the condition worse, and in some cases is enough to trigger it.

Some medications, specifically lithium, antimalarial drugs, and beta-blockers have a negative effect on psoriasis. Abrupt discontinuation of therapy with strong topical or oral corticosteroids is likely to “return” symptoms and may result in erythrodermatic or even generalized pustular psoriasis.

Is the disease curable?

- The disease does not occur as an isolated skin problem at all, but can also affect internal organs, for example the joint apparatus, and in its most severe forms leads to permanent deformation of the joints. Multiorgan involvement is also the reason for applying systemic therapy.

The approach to patients with psoriasis is strictly individual, complex and depends exclusively on age, gender and the degree of involvement of the skin and joints. In severe and moderately severe cases, phototherapy is applied. We are talking about machines that look like a solarium, but the similarity with it is only up to the appearance. The lamps used for treatment combine the beneficial properties of light without increasing the risk of developing skin cancer and the aging process.

For patients with moderate psoriasis, the best combination has been proven to be s alt water and the sun. Naturally, we appeal to the sick to make their summer vacation longer, at least 2 weeks, advising them to avoid exposure to the sun between 11 a.m. and 4 p.m., when it is strongest and most harmful to the skin.

In more severe cases, where there is involvement of a large part of the skin surface, adequate systemic therapy is applied. We have not reached the level of a complete cure, but we have the possibility of the most advanced systemic treatment. The good news for all he alth-insured Bulgarians is that when no effect is achieved with conventional therapy, we can safely resort to the most modern in the world - biological means, and this treatment is fully reimbursed by the He alth Insurance Fund.

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