World Psoriasis Day - October 29
World Psoriasis Day, observed on October 29, shines a light on challenges faced by those suffering from psoriasis and psoriatic arthritis. Psoriasis is a disease that results from an overactive immune system and is evidenced by rashes on the skin. While most immune systems take 30 or so days to push new cells to the skin, those with psoriasis push new cells within two to three days. On World Psoriasis Day, psoriasis associations strive to spread information about the condition and improve access to treatment.
History of World Psoriasis Day
The International Federation of Psoriasis Associations (IFPA) presents World Psoriasis Day to recognize those with psoriasis and/or psoriatic arthritis. It has been celebrated on October 29 for more than a decade. On World Psoriasis Day, our member associations and their supporters organize activities around the world to raise awareness of psoriasis.
Both doctors and patients have misunderstood psoriasis for centuries. While able to isolate the symptoms, the most respected medical minds of ancient times still remained baffled. Hippocrates finally replaced superstition with knowledge in treating skin ailments by introducing tar into the mix. (However, he also prescribed topical arsenic.)
The Greek physician Galen identified psoriasis as a skin disease through clinical observation and was the first to label it as psoriasis. But, along with arsenic, he suggested applying broth in which a viper had been boiled.
The condition, often mixed up with skin disorders believed contagious, led to confusion with leprosy (blame the Old Testament) and its accompanying social stigma. Officials in medieval Europe forced psoriasis sufferers to warn others of their arrival by ringing a clapper.
Per the National Psoriasis Foundation’s Ellen Seiden, “[Treatment] ideas included lubricating the skin and wrapping the body in sheets for days to create an occlusion (cover) to loosen scales. Popular applications sometimes included toxic ingredients such as nitrate, sulfur, and mercury, causing side effects harmful enough to outweigh any benefits. Most solutions were smelly, irritating, and time-consuming.”
Why World Psoriasis Day is Important
It is widespread
More than 125 million people around the world suffer from psoriasis or psoriatic arthritis. World Psoriasis Day helps disseminate important information that can help ease the pain of those living with psoriasis.
You're not alone
Through events such as runs and walks, World Psoriasis Day brings together psoriasis sufferers and their friends and family to show support for expanding treatments. The day is also marked by educational seminars designed to share the latest scientific and medical research.
Funding for new research
Through outreach to potential supporters, World Psoriasis Day raises funds for new research and expanded treatment. For those already living with the disease — especially in countries with limited medical expertise — funding is critical to providing quality medical care.
Acting Now
The COVID-19 pandemic has established health as a priority in governmental agendas all over the world. Good health impacts all aspects of people’s lives. At the country level, a healthy population is a prerequisite for prosperity.
Psoriatic disease is a systemic condition affecting multiple body sites, predominately the skin, the joints, or both. In addition to skin and joint symptoms, psoriatic disease is characterized by an increased risk of developing related non-communicable diseases and has a major impact on mental health and quality of life. In 2014, all UN nations committed to improving the lives of people living with psoriatic disease.
Practical recommendations on how to achieve this ambitious goal were published in the World Health Organization (WHO) Global Report on Psoriasis in 2016. More than 5 years after these community milestones, much is left to be done. For World Psoriasis Day, the psoriatic disease community unites to demand action.
Goal 1: Change Perception
Psoriatic disease affects the whole body – inside and out. Psoriatic disease is a systemic disease. One of its characteristics is an increased risk of developing related non-communicable diseases. The most common comorbidities are obesity, hypertension, dyslipidemia, diabetes (collectively referred to as metabolic syndrome), cardiovascular disease, and inflammatory bowel disease.
Moreover, psoriatic disease has a major impact on mental health and quality of life. People living with psoriatic disease are at higher risk of developing anxiety and depression because of their condition and because of the effect of inflammation on the brain.
Having psoriatic disease and one or more comorbidities takes a physical, psychological, and financial toll on individuals. As the COVID-19 pandemic unfolded, it became clear that some of the common psoriatic disease comorbidities, especially diabetes, obesity, and high blood pressure, are risk factors of poor outcomes from COVID-19, adding one more potential risk and burden.
In settings with adequate resources, healthcare professionals and health systems must strive to provide patients with comprehensive care from multidisciplinary teams of specialists, including dermatologists, rheumatologists, psychologists, psychiatrists, pediatricians, cardiologists, and others. Clinicians must inform patients about the possible consequences of the disease. Clinicians and patients must collaborate to identify barriers to adherence and achieve optimal management.
Goal 2: Ensure Equal Access to Medicines
Psoriatic disease is incurable, but the skin and joint symptoms of psoriatic disease can be effectively managed with medications.
Access to affordable, safe, effective, and quality medicines and technologies will achieve the optimal management of psoriatic disease and prevent the insurgence of comorbidities. All people with psoriatic disease should have equal access to the best care and treatments, wherever they live. To achieve this goal, governing bodies and health authorities should address issues such as availability and reimbursement regimens of medications, to make sure that the appropriate therapy is made available to all that can benefit from it.
The pandemic called attention to the inequalities in distribution and access to medicines, vaccines, and technologies. As for treatments and vaccines against COVID-19, the most effective medicines and technologies for managing psoriatic disease should benefit everyone, everywhere.
Member States should ensure that people suffering from psoriasis have access to professional medical care. Early diagnosis and appropriate therapy give the best chance to prevent patients from unnecessary suffering, uncontrolled disease, irreversible deformities of the joints, and disability. Patients suffering from psoriasis must have access to comprehensive, individually adapted treatment. Universal health coverage schemes should cover the costs of these treatments.
Goal 3: Stop the Stigma
Diseases that are visible on the skin are often associated with rejection or exclusion from society. What’s worse, stigmatization is often accompanied by self-stigma. Individuals with psoriatic disease can feel shame, embarrassment, and low self-esteem due to their condition. The stigma and self-stigma associated with psoriatic disease have broad repercussions. Negative reactions may lead to negative feelings, which in turn influence mental health and social interactions.
Stigma related to health conditions routinely becomes mainstream during outbreaks of infectious diseases: recent examples such as COVID-19, SARS, or HIV have shown that stigma creates hesitancy to seek testing or treatment, in addition to discrimination, hate, and racism.
Governments have a key role in reducing stigma and discrimination. Society, not psoriasis, causes the exclusion and discrimination faced by people with this disease. The situation can change through campaigns to raise awareness of psoriasis among the population and by condemning discrimination against patients who suffer from it.
Active steps by the Member States include anti-discrimination legislation and enforcement of existing legislation. Patients’ organizations and civil society have a key role in fighting discrimination and in holding governments and policy-makers accountable for their global commitments.
Goal 4: Advance Holistic Care
Achieving optimal management of complex conditions like psoriatic disease requires a shift in how health systems operate. The fragmentation of care and a disease-centered approach is not suitable for the management of an aging population often living with noncommunicable diseases. People suffering from multiple, chronic conditions require a person-centered, integrated model of care focusing not on health conditions but on individuals and their health goals.
COVID-19 has highlighted the importance of resilient health systems that can withstand the test of sudden health emergencies. Care for people living with chronic conditions was impaired while resources shifted to respond to COVID-19. For psoriatic disease, canceled appointments and initial hesitancy in starting immunomodulatory therapy have compromised care and may have triggered lasting consequences.
Optimum treatment of psoriasis, and its comorbidities, requires shifting to a model of people-centered and integrated health services. All people with psoriasis should have access to health services that are provided in a way that responds to their preferences, is coordinated around their needs, and are safe, effective, timely, efficient, and of acceptable quality.
Health services research needs to be better used in identifying specific needs of health care, unmet patient needs, and barriers to guideline-compliant treatment. Health services research should monitor and provide feedback on the actions taken to improve the quality of care and investigate the efficiency of care.
Goal 5: Prepare the Health Workforce
A high-quality and appropriately resourced health workforce is essential to manage complex conditions like psoriatic disease. Shortage of workers and irregular distribution of specialists at the disadvantage of rural areas both build disparities in care between and within countries.
The pandemic has turned the spotlight on the challenges created by shortages in the health care workforce. Even in countries with adequate health care resources, the shortage of nurses and physicians was the main obstacle for ensuring care for those who contracted the virus causing COVID-19.
Governments and non-governmental organizations should provide education on common chronic skin conditions to healthcare professionals, including undergraduate medical and nursing curricula and in-service training for physicians in primary care. There is a great need to raise awareness of psoriasis among general practitioners to increase early diagnosis and prevent disability.
All health professionals, especially clinicians working in primary health care, should be aware of psoriatic disease, its management, and its co-morbidities. Health care professionals’ associations should provide training, for example, via the Internet for physicians from low- and middle-income countries, regarding prompt diagnosis and effective treatment of psoriatic disease. Patients with psoriatic disease need access to primary health care that responds to individual needs and coordinates with specialist care.
Observing World Psoriasis Day
Take a walk
Check your local psoriasis association for runs or walks that take place on or around October 29. If there's no local association or event in your area, organize one!
Share your story
If you're a psoriasis sufferer and willing to share your story, do an interview or organize a Facebook group. Human stories are often the best way to spread awareness and help the public understand more about medical conditions.
Help educate
IFPA makes flyers and postcards available for those who want to get involved in its education efforts. Feel free to use the materials to spread the word to local schools, health clubs, and other places.
Sources:
https://nationaltoday.com/world-psoriasis-day/
https://ifpa-pso.com/world-psoriasis-day
http://cms.ifpa.stromdev.dk/tools/Now-Act-petition.pdf