Chapter 10 - Conclusion. Present and Future of Psoriasis Treatment

At the time the National Psoriasis Foundation began, psoriasis was a little known and often misdiagnosed disease.  Even now, no doctor really knows why the immune system starts attacking skin cells from the inside of the body.   Psoriasis is a chronic disorder that becomes a part of a patient’s life.  Sometimes symptoms of psoriasis disappear after a few months and do not return for years, but for other patients the symptoms are long term and persistent. Patches of thick, scaly, bright red skin often begin on the elbows, arms, legs, the trunk, or the scalp of the patient.   The most common areas for these patches are around the knees and elbows. These patches vary in size from coin size to more than five inches across.   The inflammation may typically last for weeks or months, and diagnosis and treatment are important in finding relief for the inflammations of psoriasis. The current view of the cause of psoriasis is that it might be a disorder of the immune system, as are some forms of arthritis.  Psoriasis is definitely not contagious, but it is possible that it can be inherited. The first signs of psoriasis can be found in both children and adults, with equal numbers of men and women being affected.  Psoriasis has traditionally been found in those with a northern European ancestry, though current reports show that psoriasis is spread throughout the world. A person with a diagnosis of psoriasis should make sure that their physician has recent information about treatments of psoriasis.  The options for treatment vary with the patient and the severity of the outbreak.  Nearly all physicians that treat patients with psoriasis will suggest the least aggressive treatment first, and monitor the lesions to determine how well this treatment works.  If the psoriasis responds well, then no further treatment methods will be needed.  If not, after several months the physician may suggest an alternative treatment. One of the major effects of an outbreak of psoriasis is on the emotional state of the patient.  The visible symptoms of the disease tend to be very noticeable to others in the workplace, out shopping, or in the home.  People with psoriasis usually educate the people close to them about the disease, and ease any fears that it might be contagious, or that it is a sign of some other extremely debilitating disease. It is more difficult for people with psoriasis to successfully deal with the people that they come into casual contact with.  The reactions of these people, and even possible well meaning comment, can wear away at a person.  For these reasons, support groups and counseling sessions may be nearly as important to the patients as the physical treatment. The Internet has been a big asset in educating both the general population and psoriasis patients about the current state of the disease.  Not only is information readily available, the various organizations that are concerned with psoriasis reach a much wider population.  Also, the speed of information on the Internet allows doctors to learn about new treatments almost as fast as they finish the clinical trials. One of the stalwarts of education has been the National Psoriasis Foundation, which has been supporting patients and spreading correct information about psoriasis for more than thirty years.  Though it has gone through some lean years, the value of such an organization to educate, and to advocate, and to raise funding for research has been invaluable to the community at large.  Other international organizations are also making a difference in their countries. The future is hopeful for patients with psoriasis.  A quick and accurate diagnosis, an ever-increasing choice of treatment options, and more understanding make it a very different world than that of thirty years ago.   At each flare up the disease is not easy to live with, and patients need the understanding and support of those close to them.  However, each year has more research that is done, and more understanding and support of the community at large.