For over 20 years, Mr. G suffered physically and mentally from psoriasis, preventing him from getting married, causing him to lose his job, fall into despair, depression, and even contemplate suicide several times.
Mr. NVG (38 years old, Dong Nai ) was diagnosed with plaque psoriasis when he was in 12th grade. Initially, his skin developed patchy rashes and white scales on his chest, arms, and calves 2-3 times a year, and the condition improved with hospital-prescribed treatment. However, due to his busy work schedule and inability to receive continuous treatment, he self-medicated using remedies found online or traditional family remedies.
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For about 5 years now, the disease has progressed to its most severe form: generalized erythrodermic psoriasis with psoriatic arthritis. Patients experience generalized erythrodermic inflammation, with thickened, scaly white skin extending from the hairline, eyelids, and ears down to the chest, back, and legs. Fingers and toes become swollen and permanently deformed, affecting gripping and walking functions, and causing constant pain.
Due to his skin condition and poor health, Mr. G. didn't dare get married and also lost his old job. He is currently a ride-hailing motorbike driver in Ho Chi Minh City.
When going out, Mr. G. covers himself completely in clothes, hat, mask, gloves, and socks. However, he only works a maximum of 4-5 hours a day, when the burning pain throughout his body and in his hand joints subsides thanks to painkillers.
This job is his only lifeline, helping him maintain his life and reduce his dependence on his elderly parents back home. With a monthly income of a few million dong, he frugally covers rent, food, and painkillers.
Upon interacting with the patient, Dr. Ly Thien Phuc, a specialist in Dermatology and Cosmetic Dermatology at Tam Anh General Hospital in Ho Chi Minh City, noticed that Mr. G. exhibited clear signs of depression, such as a perpetually sad and gloomy expression and reluctance to socialize.
Mr. G also shared with the doctor that he was "trapped in a cycle of illness and poverty," leading to feelings of hopelessness, depression, and self-pity. He even attempted to end his life several times, but was discovered and saved.
Suffering from the same torment of psoriasis, Mr. VHH (56 years old, Ho Chi Minh City) went from being a healthy, cheerful, and friendly person to someone easily irritable and frustrated.
After suffering a hemiplegic stroke last year, which left him with progressively deteriorating health, chronic insomnia, pain, and loss of mobility, Mr. H. became increasingly discouraged, refusing to take medication or seek treatment at the hospital.
Another case is that of LKM, a 17-year-old girl from Ca Mau , who suddenly fell ill at the prime of her life. Her skin peeled off from head to toe like snow, shocking her and leaving her unable to accept the reality. Knowing that the disease was incurable and she would have to live with it for life, she became even more desperate. "Going to school and meeting other people was torture for me," M. said.
For over a year, she suffered from psoriasis, becoming like a different person. She refused to go to school, stopped eating, suffered from insomnia, exhibited self-harming behavior, and became easily agitated when the disease was mentioned. Recalling the first time her mother took her to see Dr. Bich, M. always kept her head down, answered curtly, and burst into tears when her mask and jacket were removed and psoriasis scales fell off.
Dr. Dang Thi Ngoc Bich, Head of the Dermatology and Cosmetic Dermatology Department at Tam Anh General Hospital in Ho Chi Minh City and Tam Anh Multi-Specialty Clinic in District 7, said that they are currently treating nearly 200 psoriasis patients of all ages, genders, and disease severity levels. A common and alarming finding among all patients upon their first visit is a feeling of discouragement, confusion, and clear signs of anxiety and depression.
A study published in the Vietnam Medical Journal indicated that, among a total of 122 psoriasis patients monitored, 26.2% had depressive disorders, with severe depression accounting for nearly 22% and moderate depression for 25%.
The main, common symptoms of depression in psoriasis patients are low mood; loss of interest and enjoyment; decreased energy and fatigue; reduced concentration; pessimism about the future; and sleep disturbances. Notably, 100% of patients experience a decline in self-esteem and self-confidence. More seriously, nearly 22% have suicidal thoughts or behaviors.
The U.S. National Library of Medicine also notes a higher rate of depression in psoriasis patients compared to the general population. The agency estimates that approximately 30% of people with psoriasis have mental health issues, including depression, anxiety, and suicidal ideation. The prevalence of depression in psoriasis patients is estimated to range from 10% to 62%, depending on the criteria and scale of different studies.
Furthermore, one report indicated that 9.7% of patients wished to die at the time of the study, and 5.5% had suicidal intentions. In particular, depression worsened when psoriasis affected areas that were not visible, such as the face, palms, scalp, and nails, causing patients to avoid social interaction.
"Depression worsens psoriasis symptoms and increases the risk of complications; many people also have reduced adherence to treatment, leading to decreased effectiveness," said Dr. Bich.
In Mr. G.'s case, the doctor chose classic oral and topical medications, along with a moisturizing cream. The patient also received psychological therapy in conjunction with a psychiatrist. He was advised to abstain from alcohol and tobacco, limit fatty foods and red meat, and avoid direct sunlight to promote faster recovery.
Mr. H. and Ms. M. chose to be treated with biological injections. After two months of treatment, they overcame their feelings of illness and depression, and gradually returned to normal life.
According to Dr. Phuc, all psoriasis patients are at risk of depression. The risk is even higher for those with severe psoriasis, large areas of skin lesions, and complications; young people; and those who lack financial resources or close family support.
When suffering from psoriasis, the skin develops lesions such as redness, thickening, inflammation, and scaling, which can appear anywhere, causing cosmetic concerns, along with itching, pain, and discomfort. Patients tend to self-stigma, feel ashamed and embarrassed, and often try to hide their skin.
The lesions, which are difficult to conceal on areas such as the face, head, neck, and hands, further contribute to their feelings of self-consciousness and insecurity about their appearance. In some cases, psoriasis flares up in the genitals and breasts, making it difficult for patients to engage in intimate contact and sexual intercourse.
Some people mistake the symptoms of psoriasis for infectious diseases such as syphilis or scabies, leading to stigmatization of patients. This also causes patients to avoid contact and isolate themselves.
Psoriasis is a chronic, systemic inflammatory disease that can be managed effectively if patients adhere to treatment. Some medications cause side effects on the liver and kidneys, requiring patients to attend scheduled check-ups and undergo regular tests. Furthermore, patients must take medication for life (in mild cases, topical creams may suffice), and the cost of treatment is a significant burden for many.
If left untreated or improperly treated, the disease can easily progress to more severe forms such as generalized erythrodermic dermatitis, psoriatic arthritis causing pain, swelling, stiffness, and permanent joint deformities…
Patients are also more susceptible to developing diabetes, hypertension, hyperlipidemia, and cardiovascular disease. Information about psoriasis is widely available on the internet. Frequent access to this information, especially inaccurate information, and incorrect treatment methods can lead to wasted money and worsening health, further eroding patients' faith in treatment.
"All of the above makes people with psoriasis more susceptible to depression. In fact, younger patients experience more stress because they have a long future ahead of them, and are in the prime of their lives to build social relationships and careers, but are hindered by the disease," said Dr. Phuc.
Depression and psoriasis have a reciprocal and amplifying effect on each other. Stress is a contributing factor that can trigger or recur psoriasis. The more severe the disease, the more stressed the patient becomes, leading to insomnia and a reduced quality of life. Over time, unresolved health and psychological anxieties can lead to depression.
Both depression and psoriasis cause the body to release inflammatory cytokines. These two conditions also disrupt the levels of hormones (cortisol and adrenaline) that the body uses to fight stress, leading to a more intense inflammatory response. This, in turn, can worsen existing symptoms of depression and psoriasis or trigger new, more severe flare-ups, Dr. Bich explained.
"When the disease is controlled, skin lesions are cleared, the number of relapses is reduced, and the sequelae and complications of psoriasis are minimized, the depression in patients will improve," Dr. Bich said.
For patients with psoriasis accompanied by depression, in addition to treating the psoriasis, they need psychological support with the cooperation of their doctor and family.
Doctors encourage patients to join psoriasis patient clubs; spend more time talking to and visiting them; and encourage their family members to support and encourage them to be more positive.
Currently, there are many effective treatment regimens for psoriasis, such as classic topical medications; light therapy; systemic medications such as immunosuppressants; and most recently, biological drugs.
Among these, biological drugs represent a new breakthrough in psoriasis treatment because they control symptoms well, quickly, and with fewer side effects. Depending on the severity of the disease, the affected area of the body, comorbidities, the impact on quality of life, and the economic conditions of each patient, the doctor will recommend the appropriate treatment method.
Source: https://baodautu.vn/tram-cam-vi-mac-benh-d226146.html
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