A look at psoriasis and how to manage it

IN a recent Facebook Live, NST Insights featured consultant dermatologist Dr Peter Ch'ng to talk about psoriasis, a common skin condition in Malaysia.

Although according to the Psoriasis Association of Malaysia there are about 24,000 Malaysians living with psoriasis1, the actual figure is estimated to be much higher at 500,000 to 800,0002.

But first, what is psoriasis?

Psoriasis is a skin disorder that is driven by an overly active immune system that can affect many areas of the body.

There are varying levels of psoriasis, ranging from mild to severe, and symptoms of plaque psoriasis may include:

- Scaling spots
- Red patches on skin
- Dry, cracked skin that may bleed
- Thickened, pitted or ridged nails

People who are predisposed to psoriasis can stay symptom-free until it is triggered by some environmental risk factors. Risk factors for this skin condition could range from sunburn and injury, to alcohol consumption and certain medications.

Dr Peter, who is also the chairperson of the Cosmetic Dermatology & Laser Medicine Board of Malaysia, said that psoriasis increases the chances of developing comorbidities.

"Psoriasis is related to metabolic syndromes, which includes obesity, diabetes, hypertension, high blood cholesterol. When you have all these things, the risk of getting heart diseases and stroke (cardiovascular diseases) increases," shared Dr Peter.

He went on to explain that psoriasis is an inflammatory disease — the inflammation not only happens beneath the skin, but also in the blood vessels. This causes the vessels to be narrowed, which in turn increases blood pressure and causes a lack of blood supply to different parts of the body.

Moreover, psoriasis can be unpredictable. It can stay mild for years in some people but quickly progress to become more severe in others.

If left untreated, it may even lead to myocardial infarction (commonly known as a heart attack) and cause someone to get a stroke. In fact, several studies have shown that psoriasis is associated with an increased risk of developing severe cardiovascular diseases. 

Dr Peter also notes that traces of psoriatic memory cells may reside under healed skin and relapse even after several years of remission. Suppose someone has psoriasis on his shoulder and it went away after applying cream. But due to the presence of memory cells on his shoulder, if the psoriasis relapses, it will most likely appear at the same spot before spreading to other areas.

This is why he advocates for early treatment, as psoriasis can get more difficult to treat once it spreads. Early treatment is also important to manage the risk of comorbidities associated with psoriasis.

Thankfully, Dr Peter also says that there are various kinds of treatments available to help people with psoriasis manage this condition.

"Nowadays, there are very effective treatments to control psoriasis," he said. "If in doubt of your condition, consult your doctor. This is so we can get an early diagnosis to initiate the correct treatment, in order to prevent potential comorbidities or complications, some of which are irreversible like psoriatic arthritis." 

Some of the most common treatments for psoriasis include topical treatments like creams, ointments and gels, or systemic treatment like oral medication or injections which are usually recommended for moderate to severe psoriasis. He also recommends moisturising regularly.

Another option is phototherapy, where patients visit a centre twice or three times a week for this treatment.

Lastly, there is a class of medication called biologic therapy (biologics), the most recent treatment for psoriasis. Dr Peter explained that the drug works by blocking problematic proteins in the immune system that can cause psoriasis and its symptoms, including psoriatic arthritis, leading to stable long-term efficacy. This treatment is thought to improve and control psoriasis, as well as decrease the risk for comorbidities.

Watch the full live session of NST Insights with Dr Peter below:

For those who have or think they have psoriasis, make sure to visit the dermatologist regularly or as soon as symptoms worsen. Find out more information on how to deal with psoriasis at Psoriasis Malaysia | Mypsoriasis.my #Ask4Clear.


1. Azrul Mohd Khalid. 2021. https://galencentre.org/2021/03/29/for-thousands-psoriasis-is-a-hidden-b....

2. Zaitie Satibi. 2019. https://www.hmetro.com.my/sihat/2019/10/508829/aplikasi-urus-psoriasis-psa. Harian Metro, October 20.

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