PSORIASIS MANIFESTATIONS DURING THE WAR

Transcription

1 60 PSORIASIS MANIFESTATIONS DURING THE WAR Antigona M. Gercari Department of Dermatology, University Clinical Center of Pristine, Republic of Kosova Address: Ass. Dr. Antigona Gercari Mr. sci. Rr. Spitalit p.n. Klinika e Dermatologjisë Pristina. Kosovo. Fax: antigonagerqari@gmail.com Mybera H. Ferizi Department of Dermatology, University Clinical Center of Pristine, Republic of Kosova Address: Prof. Ass. Mybera Ferizi MD, PhD. Rr. Spitalit p.n. University Clinical Center. Clinic of Dermatology Pristine Kosovo. Fax: myberaf@hotmail.com Key word: Psoriasis, War and stress.

2 61 ABSTRACT Psoriasis is a chronic skin disorder that affects 1% to 3% of the world's population. Psoriasis is a noncontagious common skin condition that causes rapid skin cell reproduction resulting in red, dry patches of thickened skin. The dry flakes and skin scales are thought to result from the rapid buildup of skin cells. The exact cause of psoriasis is unknown, but most researchers believe that a combination of several factors contributes to the development of this disease. Psychological stress has long been understood as a trigger for psoriasis flares, but scientists are still unclear about exactly how this occurs. The cause of stress varies in each person. Stress could be caused by nature of work, state of finances, family worries. In some cases even positive developments such as marriage or child birth can cause stress and lead to Psoriasis. The aim of our study was to compare the impact of stressful life during the war period as the cause of manifestation of psoriasis in the years 1999-th and post-war period in the 2009-th. INTRODUCTION Psoriasis (derived from the Greek word psora meaning to itch) is a common immunemediated papulosquamous skin disease. First recognized as an independent condition by English dermatologist Robert Willan in 1798, the term is now used to include a variety of clinical appearances with different morphology, distribution, severity and course. People worldwide develop psoriasis. In the United States, nearly 7.5 million people have psoriasis and about 150,000 new cases are diagnosed each year. Studies indicate that psoriasis develops about equally in males and females. Research also shows that Caucasians develop psoriasis more frequently than other races. A study conducted in the United States found the prevalence was 2.5% in Caucasians and 1.3% in African Americans (1). Although common, the pathogenesis of psoriasis is not well understood and involves a multitude of genetic and environmental factors. It is common for psoriasis to be found in members of the same family.psoriasis commonly affects the skin of the elbows, knees, and scalp. Some people have worsening of their symptoms in the colder winter months. Many people report improvement in warmer months, climates, or with increased sunlight exposure. (2). Scientific studies confirm that stress can worsen psoriasis and increase itching. Physical and psychological stress can stimulate the release of chemical messengers called neuropeptides, which can cause pain, itching, and inflammation. Based on these observations, stress appears to be one of many psoriasis triggers. The way stress affects the patient varies from individual to individual; the most common manifestations are psychological depression, anxiety, and obsessional behaviors (3).We conclude from our study, during the daily stresses of the war-period and during the peace in the state have not significant difference in the manifestation of psoriases. METHODS AND MATERIALS This study presents results from a retrospective study of all out-psoriatic patients in dermatological clinic during the 1999-th year the war period, and during the 2009-th year of peace. In this study were included all patients from 3 years of age or older than 60 years, both sexes, and had a medical diagnosis of psoriasis. The most frequent age and gender, epidemiology during the years 1999/2009, and climate impact in improvement of psoriases were analyzed using the computerized programs. RESULTS From the material researched conclude that the total number of visited patients in Dermatology Clinic during the 1999 year, the number of patients with psoriasis was 134 (1:36%)cases. Female was more appealing to 71 (1:58%) cases. Throughout months of 1999 th with the largest number of patients with psoriasis were December in 26.86% and

3 62 January in 21.64%, but fewer cases were July and August 0% 0%. During the 2009, from all visited patients in Clinic of Dermatology, the number of patients with psoriasis was 429 (3.69%) cases. Women are more often attacked 221 (51.51%) cases. Number of patients with psoriasis were in December with 41 (9:55%) and January with 52 (12.12%) with more cases. And months with fewer cases were July with 8(1.86%) and August 12 (2.79%) cases. DISCUSION Psoriasis is more stress sensitive than many other skin diseases (2). Many stressful events of daily life may exacerbate psoriasis (3).Scientific studies confirm that stress can worsen psoriasis and increase itching. Some people can even trace their first outbreak to a particularly stressful event. Most people living with psoriasis experience good days when their skin clears and bad days when psoriasis flares. When the everyday stress of living with psoriasis is compounded by a stressful event at work, a personal crisis, or an especially hectic time, such as the holidays, the stress can feel overwhelming.(4,5,6).the patient with psoriasis should seek help from a dermatologist when psoriasis is complicated by psychosocial difficulties.(7).in some cases, psychosocial problems may be alleviated when the patient is enrolled in a support group or referred for psychological counseling.(8) War is a state of stressors for everyone and for psoriatics. The state of war affects the same as the daily stressors of life situations. We conclude from our study, during the daily stresses of the war-period and during the peace in the state have not significant difference in the manifestation of psoriases. REFERENCES 1. Callis Duffin K, Wong B, Horn EJ et al. Psoriatic arthritis is a strong predictor of sleep interference in patients with psoriasis. Journal of the American Academy of Dermatology 2009; 60: Gudjonsson JE and Elder JT. Psoriasis. In: Wolff, K, 2.Goldsmith LA, Katz SI, et al. Fitzpatrick s Dermatology in General Medicine. 7 th ed. New York: McGraw Hill Medical; p Gupta MA, Gupta AK. Psychodermatology: an update. J Am Acad Dermatol 1996; 34: Behnam SM et al. Smoking and psoriasis. SKINmed May-June;4(3): Bowcock AM et al. Genetics of psoriasis: The potential impact on new therapies. Journal of the American Academy of Dermatology August; 49(2):S Murase, JE et al. Hormonal Effect on Psoriasis in Pregnancy and Post Partum. Archives of Dermatology May; 141(5): McKenna MB, Stern RS. The outcomes movement and new measures of the severity of psoriasis. J Am Acad Dermatol 1996; 34: ). 8. Zachariae R,Oster H, Bjerring P, Kragballe K. Effects of psychologic intervention on psoriasis: A preliminary report. J Am Acad Dermatol 1996; 34: ).

4 63 Table 1: Number of patients with psoriasis in 1999 Number of patients Total Males Females All visited patients % % With psoriasis % % % Table 2: Number of patients with psoriasis according to age and sex in 1999 Gender vj vj vj vj. 60 Total 10year Males % Females % Total % % % % % 6 4.4% % 134 Table 3: Number of patients with psoriasis according to calendar months during 1999 Month M F Total January February March April May / 5 5 June July / / / / August / / / / September / / / October November December Total Table 4: Number of patients with psoriasis in 2009 Number of patients Total Males Females All visited patients % % With psoriasis % % %

5 64 Table 5: Number of patients with psoriasis according to age and sex in 2009 Gender 3-10vj vj vj vj vj vj. 60 Gjithsej Males Females % Total % % % % % % % 429 Table 6: Number of patients with psoriasis according to calendar months during 2009 Month M F Total January February March April May June July % August % September October November December Total