Myths and realities of Psoriasis
- Aug 17, 2015
- 4 min read
Updated: Mar 21
Radio Interview - Soundcloud [07:26]
Topic: Psoriasis
Title: Myths and Realities of Psoriasis
Day by Day with César Miguel Rondón - Health and Wellness
August, 2015
* Click on the image to see the full interview.
César Miguel Rondón (CMR): I'm very pleased to welcome Dr. Denise Mago, an internist and dermatologist. She practices at Clínica Vista Alegre and the Centro de Bienestar Activo (Active Wellness Center), and we're going to talk with her about the myths and realities of psoriasis. Denise, welcome to this morning's program. Dr. Denise Mago: Thank you! 1) CMR: Okay, first of all, what is psoriasis? How do we define it? Dr. Denise Mago: "Psoriasis is an inflammatory disease characterized by red areas on the skin covered with silvery scales. This can manifest as plaques, or it can also appear as drops on the chest". 2) CMR: In drops?
Dr. Denise Mago: "It's the guttate form; the lesions are like drops on the chest and can appear all over the body. This type of psoriasis is more common in young people and children. There's also an erythrodermic form, in which the person becomes completely red, and a pustular form, where pustules form all over the body on top of the initial psoriasis lesions".
3) CMR: Why does this happen?
Dr. Denise Mago: "Well, this is a genetic disease, but not a hereditary one. It's genetic because it's determined by each person's genes and manifests itself when there are environmental conditions that trigger it to appear, or in a palpable way".
4) CMR: What kind of environmental conditions?
Dr. Denise Mago: "For example, in children, streptococcal throat infections can be caused by stress, and these are the most frequent causes of an exacerbation of the disease”. 5) CMR: Stress in children, right?
Dr. Denise Mago: "No. Children with throat infections, strep throat, can develop psoriasis later. And no, stress in adults, of course. Haha”. 6) CMR: Ahh... because otherwise...
7) CMR: Okay, Denise, when we talk about myths, what's the most common myth surrounding psoriasis?
Dr. Denise Mago: "The most common myth is that psoriasis is contagious, and that's why many patients with this disease are rejected for jobs, by other people, from joining groups, or by romantic partners. This is the most frequent.
Another myth is that it's a disease that only affects adults and that it's caused by stress. No, it's not caused by stress. As we discussed earlier, it's a genetic disease, but it's not hereditary. A person with psoriasis won't necessarily have children with the disease".
8) CMR: Is psoriasis curable now? All psoriasis? Because when we're talking about these marks, these skin lesions, we're talking about something very visible.
Dr. Denise Mago: "Yes, psoriasis isn't curable per se, but there are now new medications that, in severe psoriasis, cause the lesions to disappear. So, when the external symptoms disappear, the patient looks as if they don't have the disease. These treatments are long-term”. 9) CMR: How long, Denise?
Dr. Denise Mago: "Well, they can be for life. There are studies starting now to try to develop an alternative treatment, that is, alternating biologics with other types of treatments to use them for a shorter period".
10) CMR: Why is it incurable?
Dr. Denise Mago: "Because it's an autoimmune disease, it's a disease that's always there, but psoriasis patients now have many options because before there were only topical treatments; now there are other types of treatments, including oral treatments like methotrexate, and phototherapy".
11) CMR: How does phototherapy work? Laser beams, something like that?
Dr. Denise Mago: "No, phototherapy works with UVA and UVB light chambers. Patients enter these chambers, and it's like sunbathing, but with a different wavelength".
12) CMR: Now, when we're talking about the patient beyond the physical aspect, and the psychological factor of feeling rejected, what other physical or somatic problems does this type of patient have?
Dr. Denise Mago: "Well, very dry skin, which can cause a lot of itching, and the lesions can open up. There's a type of psoriasis called 'palmoplantar' psoriasis, which is one of the most difficult to treat. The patient can't even walk; the skin on their feet and hands opens up completely, leaving them severely disabled". 13) CMR: When do you say they open?
Dr. Denise Mago: "They're fissures in the skin". 14) CMR: Like cracks?
Dr. Denise Mago: “Exactly".
15) CMR: And in this case, what type of treatment do you apply?
Dr. Denise Mago: "Biologics. These are the new treatments I was telling you about, which are subcutaneous injections. Some are given weekly and others every two weeks, but this is only used for patients with this type of psoriasis and patients with severe psoriasis. There is another important manifestation of psoriasis called 'inverse psoriasis,' which occurs in the genitals, in the entire genital area, the pubic area, and this prevents, that is, free sexual relations with a partner".
16) CMR: And is this true for both men and women?
Dr. Denise Mago: "Yes, for both men and women". 17) CMR: Yes, I imagine it must be a very delicate situation.
Dr. Denise Mago: "Of course, because these lesions, in addition to having plaques, are very erythematous, very red, and the skin becomes very sensitive. This is also an indication for biologics. Biologics have really evolved in the treatment of psoriasis because before, there were only topical treatments. This led to a more careful approach to these patients, and it was discovered that psoriasis is a metabolic disease, a disease that occurs in patients who are obese, diabetic, or have cardiovascular problems. Therefore, these patients are now being treated holistically”. 18) CMR: Very good, Denise, thank you so much for joining us on the program this morning. Dr. Denise Mago is an internist and dermatologist at Clínica Vista Alegre and Centro de Bienestar Activo (Active Wellness Center). Thank you so much for coming.
Dr. Denise Mago: Thank you!
