03 Oct Another Look at Chronic Diseases: Skin Pathologies
Guest Blog by Corina Vladut:
HealthCare Minds is delighted to introduce Corina Vladut as guest blogger. Corina is a health psychologist with special interests in research, chronic disease management, psychosomatics, mental health, quality of life and health technology:
When we think about chronic diseases, conditions like diabetes or cardiovascular diseases come to mind and we rarely include chronic skin diseases among our thoughts. Unlike people suffering from these “internal” chronic diseases, patients with skin pathologies often carry a double burden, one related to the psychosocial difficulties encountered (stigmatization, negative emotions, self-blame) and the actual medical problems, such as pain or scratching.
Probably one of the most common and debated skin diseases is psoriasis. Ranked as the second most common dermatological disease worldwide, psoriasis is characterized by both multiple different phenotypical variations and degrees of severity, as well as high rates of morbidity. The severity of psoriasis can vary dramatically, from one or two small plaques to extensive coverage of more than 90% of the body’s surface area.
A consistent amount of data suggests a strong relationship between severity of psoriasis and stress reactions, with a modulating effect of psychosocial factors on both the central nervous and immune system’s functioning. Due to this relationship, adjustment in psoriasis greatly differs between individuals. These variations are related to characteristics such as age, cognitive processes, perception of disease, or exterior aspects, such as type of received treatment or environmental factors. Thus, maladjustment in psoriasis is sustained by the interaction between biological and psychological factors. For example, psychological distress is one of the principal predictors of time taken for photo-chemotherapy to clear psoriasis.
As the disabilities caused by this skin disease are comparable or greater than other medical conditions, the management of psoriasis requires careful attention. Further challenges in the management of this disease are posed by the fact that adjustment to psoriasis depends on diverse factors (such as beliefs, coping strategies, personality, financial resources). The management of psoriasis should include both dermatological treatment and psychological palliative care, as it would improve the patient’s physical and psychological quality of life, thus reducing the costs associated with the treatment of the disease.
References available on request