20000519-It is very important for patients with psoriasis to understand their disease.

Psoriasis is a chronic skin disease that affects between 1 and 4% of the population. Its incidence varies from country to country and region to region, because it is attributed to environmental factors and Genetics . Navarra is an area with a high incidence of psoriasis.

discussion This ailment, characterized by reddish plaques covered with thick scales, mainly located on elbows, knees and scalp, is one of the pathologies discussed at the V National Dermatological Nursing congress "Sun and skin", which was held at the University of Navarra from May 18 to 20.

area According to Dr. Pilar Gil, from the Dermatology Department of the Clínica Universitaria de Navarra, "psoriasis begins to manifest itself between the ages of 15 and 30. In children it is exceptional, because it usually manifests 'in drops', associated with infectious processes (pharyngitis, tonsillitis) and can be cured with antibiotics. There is also psoriasis in infants, which affects the areas covered by the diaper".

In adults, there is still no curative treatment: the only solution is to bleach it in different ways, although the effect is not definitive, because it can resurface with any triggering factor, such as stress or emotional shocks (childbirth, death of a loved one...).

Treatments are applied depending on the extent: if it is localized, topical means are used: "They are reducers such as anthralin or keratolytics. Lately, vitamin A and D derivatives have been used," explains Dr. Gil.

However, if the psoriasis is generalized (occupying approximately 30% of the body surface), systemic treatments are used, whether classical (phototherapy, retinoids, methotrexate) or modern (immunosuppressive drugs such as cyclosporine, mycophenolate mofetil or tacrolimus).

New research

"Phototherapy," comments the dermatologist from the University of Navarra, "is performed in two ways: with ultraviolet B (UVB) rays and by combining the administration of a drug with ultraviolet A (UVA) radiation. The response of psoriasis to phototherapy is good, and now wavelengths are being developed that are as effective as conventional ones, but with fewer side effects, since UVA and UVB have side reactions".

As for the new immunosuppressive drugs, "the problem lies in the fact that they require a control analysis and are drugs that we cannot keep for the rest of our lives, because there is a risk of developing tumors. So two problems come together: the fact that psoriasis is a chronic disease and that these treatments cannot be prescribed continuously because of their side effects. The solution is rotational therapy, in which the various drugs are prescribed periodically," the expert concludes.

In addition, according to a recent study carried out by the Reina Sofia Hospital in Tudela, it has been concluded that more than 20% of those affected resort to alternative medicine. "You have to be careful," warns Mª Carmen Martín de Aguilera, nurse at area Dermatology of this hospital center, "because some healers sell patients very powerful corticosteroids that cause a rebound effect on the skin: they whiten the psoriasis quickly, but it sprouts again more hardened.

A disease that tires the patient

"We are faced with a strange phenomenon," adds the nurse, "because people are clear that the condition is not contagious, but then, and especially women (1 in 3), take preventive measures when living with people with psoriasis. In addition, 32% of those surveyed consider it to be a problem in their social and working life".

Another very important circumstance is for the person affected by psoriasis to understand their disease, which is "chronic and dependent on outbreaks," according to Dr. Gil. "In this sense, the work of nurses is very important, because they have a more direct contact with patients and can teach them to live with the disease."

In this regard, Mª Carmen Martín de Aguilera comments that "the role of nurses is mainly supportive, because they teach how to apply the treatments for this chronic disease, which often ends up exhausting the patient. That is when they should encourage the patient to continue with the treatments.