Patients in Singapore with psoriasis are also more likely to suffer from anxiety: Survey
EVERY time a 37-year-old senior marketing manager here leaves his house, he dons his “uniform” of long-sleeved shirt and full-length trousers. It does not matter where Mr Kaye, who does not want to reveal his real name, is going or how hot the day is. His sartorial choice hides a secret from other people and even his friends, colleagues and the girlfriends he has had in the last 17 years. He has a severe form of psoriasis, a chronic inflammatory skin condition characterized by red, scaly lesions known as plaques. When it flares up, the skin from his ankles to his wrists is itchy and prone to flaking off. The disfiguring appearance comes from the skin cells multiplying rapidly, making the skin thicken and become scaly.
The National Skin Centre (NSC) estimates that at least 13,000 people here have psoriasis, making it one of the 10 most common conditions treated there. And those in Singapore with psoriasis seem to have it worse than people elsewhere: A survey commissioned last year by Janssen, a subsidiary of pharmaceutical giant Johnson & Johnson, showed that 71 per cent of those with psoriasis in Singapore have the severe form, compared with 24 per cent and 55 per cent in China and South Korea respectively.
The disease is considered severe if it affects more than 10 per cent of the body. In severe cases, psoriasis is also associated with joint problems such as arthritis. Some studies have shown that colder temperatures worsen the condition, but doctors attribute the higher incidence of severe cases here to stress.
Dr Lim Kar Seng, a consultant dermatologist in private practice, said: “The lifestyle and pace of life here could be more stressful than in countries such as South Korea and China, which are more rural.” Other factors such as smoking and obesity have also been linked to an increased risk of psoriasis.
The survey, which polled 980 patients in the three countries, also revealed that those in Singapore are more likely to suffer from anxiety as a result of their condition; 48 per cent show signs of the mood disorder, compared with 45 per cent in China and 35 per cent in South Korea.
Dr Pan Jiun Yit, an associate consultant at the NSC, said psoriasis can impair one’s quality of life and become an economic and social burden to patients and their families. He added that studies have shown that its impact on one’s quality of life can be comparable to that of chronic medical conditions such as diabetes. Dr Lim added that psoriasis patients here may be more anxious than those elsewhere because they are worried their appearance could hurt their job prospects.
Mr Kaye said: “People here are superficial and concerned about the way they look, especially in the consumer-centric industry I work in. I am worried about facing discrimination.” He had a mild condition at first, but the small patches on his back and fingernails flared up six years ago after a period of high stress at work. He has been unable to find full-time work since.
Conventional treatment for psoriasis involves topical creams, phototherapy or oral medication, but the latest treatment involves injections or intravenous infusions, which work by blocking the action of a specific type of immune cell. Biologics, or drugs derived from living cells, can be used by patients with moderate to severe psoriasis, or those for whom oral medications do not work. One downside: It is expensive. At about $1,500 to $2,000 a month, it costs about twice as much as traditional medication. Another downside is that, because it is relatively new, doctors do not know its long-term safety profile.