Uncovering psoriasis on Universal Health Coverage day

On International Universal Health Coverage day 2022, Dr Sunil Dogra, Professor, Department of Dermatology, Venereology & Leprology, PGIMER, Chandigarh highlights the possibility of bringing psoriasis under Universal Health Coverage and the impact it has on a person financially

12^th December is the Universal Health Coverage (UHC) day, a day especially dedicated to ensure that people get quality treatment and health services without any financial hardships. Conceived by WHO for patients, UHC day is a truly global event and contributes to Sustainable Development Goals associated with health.

Psoriasis is a common chronic skin disease affecting about 3 per cent of the world population. In a study of 419 children seen at the Psoriasis Clinic of Post Graduate Institute of Medical Education & Research, Chandigarh over a period of 13 years, there were 219 (52.2 per cent) boys and 200 (47.7 per cent) girls, with a male to female ratio of 1.09: 1. The age of onset ranged from 4 days to 14 years. It can affect any age, sex, or race. It is an immunologically mediated disease influenced by genetics, personal and environmental factors. This disease distresses millions of people all over the world and patients may suffer from cosmetic disfigurement and hence face social stigma. More than anything, they sometimes bear the brunt of public rejection because of the misconceptions surrounding the disease. UHC can provide an opportunity to develop a structure for improving the effectiveness of psoriasis care, specifically if implemented through well-equipped, accessible, and high-quality primary health care services.

The management of this disease requires the patients to recognise their own disease and seek treatment, enable public to realise that psoriasis is not contagious and halt discriminating behavior, and to facilitate the medical community for diagnosis and effectively treat the disease. In 2014, Member states recognised psoriasis as a serious Noncommunicable Disease (NCD) in the World Health Assembly, they highlighted that many people in the world suffer needlessly from psoriasis due to misdiagnosis or delayed diagnosis and insufficient access to care.

Topical therapies (creams/ointments/lotions) are the mainstay of treatment for mild disease whereas severe disease can be effectively managed through various systemic drugs and phototherapy. Patients not responding to conventional drugs can be effectively managed with targeted therapies like oral small molecules biologic therapy. A positive lifestyle, stress management, weight control, yoga, meditation, and walk are essential components of disease management.

Delay in early detection of psoriasis may increase the risk of other NCD’s, resulting an increase of financial burden, which means it would be a lifetime constituting reason for substantial financial obligation if not backed by universal Health coverage schemes. UHC could be considered as a smart and valuable investment in socio-economic welfare, promoting flourishing and a healthy society.

Essential facts about psoriasis Psoriasis can affect anyone, anywhere, psoriasis knows no borders Psoriasis is not infectious or contagious Psoriasis patients should keep their weight, blood pressure and cholesterol under control Avoid alcohol intake and smoking There is no apparent relationship between diet and psoriasis Stress management is helpful for disease. Have a positive attitude in life and self confidence Always use the treatments prescribed by a qualified dermatologist Treatment by quacks, advertised over internet with promising claims, having no scientific basis often makes disease worse and non responsive to usual medication. You should be regular in follow up with your treating doctor, avoid self medications Psoriasis patients can lead a normal life Keeping skin moisturised with oils and sun exposure is beneficial Discuss your problems of psoriasis with your dermatologist, become partner in treatment decisions.