Is psoriasis infectious? [Archives:2007/1030/Health]

March 5 2007

Almigdad Dahesh Mojali
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Most Yemenis instinctively are disgusted and try to avoid being with those who suffer any type of skin disease, without any previous knowledge about whether the disease is infectious or not. As with any other skin disease, many citizens think psoriasis is infectious, but it isn't. Although it's good to avoid patients and to be careful, others sometimes increase such patients' ordeal and cause many additional troubles for them.

Psoriasis is a common chronic disease, but it isn't infectious. Dermatologist and allergist Dr. Mohammed Al-Shami explains, “I don't know why people judge psoriasis as an infectious disease. Psoriasis isn't infectious; rather, it's a common, chronic, scaly rash affecting those of all ages. The most common ages for psoriasis to first appear are in the late teens and in the 50s. It affects men and women equally, although in children, girls more commonly are affected than boys.”

Medical studies reveal that psoriasis has been shown to affect health-related quality of life to an extent similar to the effects of other chronic diseases such as depression, heart attack, hypertension, congestive heart failure or type 2 diabetes.

Depending on the severity and location of outbreaks, individuals may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions such as caring for oneself, walking or sleeping. Infected areas on hands and feet can prevent individuals from working at certain occupations, playing some sports and caring for their family members or the home.

Individuals with psoriasis also may feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns. Psychological distress can lead to significant depression and social isolation.

“People must be careful to avoid diseases, but such carefulness, which sometimes is associated with disgusting behavior toward psoriasis sufferers, sometimes may increase their ordeal and lead to bigger troubles,” Al-Shami noted.

Mohammed Al-Yarimi, 26, from Ibb describes, “I became infected by psoriasis four years ago. When it began, people started deserting me and stopped accompanying me. I went to the doctor and he told me it isn't infectious. I wanted to inform people that the disease wouldn't infect them, but I refrained because I knew they wouldn't believe me. Because the disease is chronic, I spent about two years apart from other people and friends because I reached a point where I didn't want to accompany them.”

He added, “Just imagine sitting among people who are disgusted by you. Could you bear that?”

The brother of 24-year-old E.S. from Dhamar expressed, “When she became infected by psoriasis, her friends spread the news and many others began spreading it too. Her fiance heard it and broke their engagement after five months. We knew the disease wasn't infectious and she started recovering, but we were really ashamed of people.”

One man requesting anonymity recalled, “A month after my wedding, I discovered that my wife had psoriasis. I knew that when her medicine finished, she didn't have money to buy more. She was so frightened and afraid that I might divorce her. In the beginning, I deserted her for a month, but when I learned that psoriasis isn't infectious, I went back to her.”

However, Ameen Al-Maswari, 35, from Sana'a has a different experience. “I was infected by psoriasis, so I went to a doctor. Although I didn't use the medicine he gave me, I recovered after six months.” He added, “I didn't feel shy around people and they weren't disgusted at me.”

According to Al-Shami, psoriasis is an immune-mediated disease, affecting the skin and joints, commonly causing red scaly patches to appear on the skin. Such scaly patches, called psoriatic plaques or lesions, are areas of excessive skin production and inflammation. Skin rapidly accumulates at these sites and takes on a silvery-white appearance. Plaques frequently occur at the elbows and knees, but can affect any area, including the scalp and genitals. Psoriasis isn't contagious.

The disorder is a chronic recurring condition varying in severity from minor localized patches to complete body coverage. Additionally, fingernails and toenails frequently are affected and this is called psoriatic nail dystrophy. Psoriasis also can cause joint inflammation, which is known as psoriatic arthritis. Ten to 15 percent of those with psoriasis have psoriatic arthritis.

Psoriasis is probably one of the longest known human illnesses and simultaneously, one of the most misjudged and misunderstood. More recently, psoriasis frequently was described as a variety of leprosy. It became known as Willan's lepra in the late 18th century when English dermatologists Robert Willan and Thomas Bateman differentiated it from other skin diseases.

While it may have been visually, and later semantically, confused with leprosy, it wasn't until 1841 that the condition finally was named psoriasis by Viennese dermatologist Ferdinand von Hebra. The name is derived from the Greek word psora, meaning to itch. Psoriasis was further differentiated into specific types during the 20th century.

To date, specialists don't know what causes psoriasis exactly, although they know most of its risk factors. “What causes psoriasis isn't fully understood, but I can say that the immune system is involved and appears to be overactive in a way that causes inflammation. This also causes growth of extra blood vessels within the skin, causing the red color, and increased turnover of skin cells, which causes scaling and thickening of the skin,” Al-Shami explained.

Although the exact causes of psoriasis aren't known, many risk factors highly contribute to its infection, including stress and excessive alcohol consumption. Moreover, studies prove that like most diseases, psoriasis is influenced by inherited characteristics where those with a family history of the condition tend to develop it earlier in life than those without a family history.

Additionally, Al-Shami clarified that pregnancy also may have an effect on the severity of psoriasis; noting that it usually improves with the potential for worsening after the baby's birth, but the reverse also can occur. However, he stressed that psoriasis doesn't affect the unborn child.

No studies or statistics are available in Yemen to show the actual number of psoriasis sufferers, but many Yemeni dermatologists confirm that those with psoriasis may suffer from depression and loss of self-esteem. As such, quality of life is an important factor in evaluating the severity of the disease.

Psoriasis has many types, whose causes and treatments differ from one to the other. “Actually, there are many types of psoriasis. The most common type among Yemenis is plaque psoriasis. It is considered a persistent or chronic type, which can be treated with medication, but it's difficult to clear up completely with topical treatments alone. It involves large flat plaques of psoriasis with the typical silvery scale. These plaques may fuse together to involve very extensive areas of skin, particularly on the torso and limbs,” Al-Shami explained.

He continued, “Another type is guttate psoriasis, which is multiple tiny areas of psoriasis that tend to affect most of the body. Lesions are usually around the torso, upper arms and thighs. The face, ears and scalp also are commonly affected, but lesions in these areas may be very faint and quickly disappear.

“Psoriasis can affect the palms and soles where they become very dry and thick with some cracking,” Al-Shami added, “In brief, psoriasis can affect most body parts, but it has many types and causes according to the part of the body it affects.”

Umm Abdulrahman Al-Hababi, 38, notes, “I've had psoriasis on my arms and scalp for about five years. I went to many doctors, but I find the recovery progress very slow, although I take my medicine on time and persistently.”

Al-Shami stresses, “Indeed, until now, there's no cure for psoriasis, but it's possible for most patients to control the disease.”

“Psoriasis is one of the most difficult skin diseases to treat due to its numerous and various types and causes, but there are many recommendations and ways that can help treat it,” dermatologist and allergist Dr. Nabeel Abdu Sa'eed says.

“A psoriasis patient should be exposed to sunshine, which may clear up the condition. Also, the patient can soak in warm water with bath oil and use some cream like Vaseline or emulsifying ointment to soften the skin and prevent it from becoming sore,” Sa'eed added.