Psoriasis is a chronic disease with a disorder of the autoimmune system. Although it is not contagious, the skin will show symptoms such as scales of different sizes, bright red or dark red rashes. According to the Department of Health, there are about 20,000 cases of varying degrees in Hong Kong. Patients, moderate to severe patients accounted for 30%.
Concerned organizations have conducted an earlier survey on the status of psoriasis patients. The study found that more than 60% of patients induced different "comorbidities" due to poor treatment, which severely affected their daily lives, and even more patients suffered discrimination and depression.
The organization hopes that the government can lower the threshold for applying for the use of drugs, and learn from other countries to set up integrated treatments to help patients return to normal lives.
The Hong Kong Society of Psoriasis Questionnaire Survey 2021 will be conducted from July 28th to August 4th with an online questionnaire.
The study found that 70% of patients were treated with external medicines (ointments) used by doctors, and 80% of the patients believed that the treatment method would not help or even worsen the condition of the disease.
(Photo by Zeng Fengting)
The patient has been waiting for at least 1 year to 3 years for face-to-face consultation within 5 minutes
The Hong Kong Psoriasis Friends’ Association Questionnaire Survey 2021 was conducted from July 28 to August 4 with an online questionnaire. Data of 122 patients were collected. All the patients interviewed had been or were in the Department of Health Dermatology Clinic or East District Youde Mrs. Nethersole Hospital received treatment at the Biological Treatment Clinic.
The study found that 70% of patients were treated with external medicines (ointments) used by doctors, and 80% of the patients believed that the treatment method would not help or even worsen the condition of the disease.
More than 60% of the interviewed patients have developed different "comorbidities", that is, psoriasis attacks the immune system and then induces other diseases, mainly psoriatic arthritis (35%), hypertension (25%), and high blood pressure. Cholesterol (14%), depression (12%) and diabetes (10%).
Among them, only half of the comorbidities were referred to specialists in public hospitals for corresponding treatment, and 90% of the patients interviewed hoped for more advanced and effective treatment.
Research reveals that patients need to wait for at least 1 to 3 years, and more than half of the interviewed patients have an average face-to-face consultation time of only 5 minutes.
Li Qingkun, chairman of the Hong Kong Psoriasis Friends’ Association, said that he understands the current shortage of resources in public hospitals. However, it takes an average of three and a half years to wait for a new psoriasis disease. Appropriate treatment has been obtained, leading to deterioration of the condition and the appearance of different comorbidities.
In addition, the Department of Health’s dermatology department mostly focuses on the treatment of patients’ skin problems, and does not provide assistance to the comorbidities and mental illnesses they extend. Many patients have suffered discrimination and depression, but the patients have not received Referral to psychiatric treatment.
(Left) Ms. Chen (pseudonym), a patient with psoriasis, fell ill two years ago. (Right) Li Qingkun, chairman of the Hong Kong Psoriasis Friends Association, said that the Department of Health’s dermatology department focused on dealing with patients’ skin problems and was not responding to them. Co-morbidities and mental illnesses can be extended to assist.
(Photo by Zeng Fengting)
Ms. Chen (a pseudonym), a psoriasis patient, said that she had developed symptoms two years ago. At first, the symptoms appeared only on part of the scalp. So she went to the outpatient clinic of the Hospital Authority. When the doctor diagnosed psoriasis, she informed her that the outpatient department did not have any symptoms. For suitable skin drugs, it is recommended that Miss Chen buy a specific shampoo in the pharmacy to relieve her condition.
Unexpectedly, after only two months of illness, the affected area of the scalp expanded from the size of her fingers to the size of a palm.
"I thought I would be saved by buying shampoo and returning it to use."
Just two months after the onset of Ms. Chen, her scalp symptoms expanded from the size of her fingers to the size of a palm.
(Photo provided by the Hong Kong Psoriasis Friends Association)
The patient's depression induced by the illness
Ms. Chen was referred by the Hospital Authority to the Department of Health's Dermatology Department for more than a year. During this period, she could only go to private hospitals and Chinese medicine practitioners, and used ointments and shampoos provided by private doctors. She also had to pay special attention The weather changes, and be careful not to let direct sunlight hit your head.
"The weather in Hong Kong is hot and humid. It's not too comfortable. Wear a top hat and bake it. Wear a more breathable hat. If you bake it, your scalp will be scarred." Ms. Chen's condition caused her to suffer discrimination when cutting her hair.
"I don't want to cut it as soon as I see it. I know it, but I'm so embarrassed, I don't want to cut it and it will be too hot."
The affected area of Ms. Chen's scalp deteriorated to bleeding and thickening. She had to go to the Accident and Emergency Department for medical treatment. In October last year, she successfully met with a dermatologist from the Department of Health.
However, even if she had a follow-up consultation every four months, the doctor would only "look a few eyes" each time, and the face-to-face consultation time would not be more than 4 minutes. She continued to prescribe the same steroid ointment and shampoo, only to stabilize her condition and not to worsen. .
Ms. Chen said that she was dissatisfied with the doctor's attitude towards face-to-face consultation. She asked to change the doctor, but the nurse refused.
"I have been prescribed the same medicine all day long. I'm so surprised that I don't have the tail docked, but can I do it well?" At present, Ms. Chen is also suffering from comorbidities caused by psoriasis, and she has three high problems. Depressed.
Li Qingkun, chairman of the Hong Kong Psoriasis Friends Association, suggested that the government can follow the example of other places to implement standardized medical care and lower the threshold for patients to use biological agents.
(Photo by Zeng Fengting)
Li Qingkun, chairman of the Hong Kong Psoriasis Friends Association, suggested that the government implement standardized medical care, such as the standardized diagnosis and treatment center for psoriasis in the Mainland, the Holstein University Medical Center in Germany and the National Skin Center in Singapore to set up a special treatment for psoriasis patients. And the integrated treatment designed for patients is regularly evaluated in different aspects to stabilize their condition.
Biological agents are said to be the best treatment for patients with psoriasis.
However, there are many limitations if patients want to use it.
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The threshold of application for biologics therapy is too high
Li Qingkun also said that Hong Kong has too high a threshold for referral of biologics for patients with psoriasis, but this method works best for patients.
If a patient uses biological agents through a public hospital, there are two restrictions. One is that the condition must be moderate to severe (that is, there are about ten palm-sized rashes on the body); Use two of these to achieve the highest dose, have side effects or are ineffective. If one of the two conditions is met, the Department of Health's dermatology department can refer to the HA for treatment with biological agents. The average cost of medicine is at least 7,000 yuan per month; By skipping the relevant steps, patients can only go to specialist clinics in private hospitals. The cost of biological treatment drugs has risen to between 8,000 and 10,000 yuan per month. Many patients cannot afford it. At present, only 56 patients in Hong Kong use biological preparations.
He hopes that the government can lower the threshold and provide corresponding subsidies so that more patients can return to their normal lives.
Psoriasis is a non-infectious skin disease, a disorder of the systemic immune system caused by the imbalance of inflammatory cytokines throughout the body.
The patient's skin will appear bright red or deep red rashes, itching, and covered with layers of silvery white or grayish brown scales.
The main parts of psoriasis are the scalp, ear shells, elbows, outside finger joints, back and knees.
Psoriasis mostly appears symmetrically, that is, psoriasis on one hand and the other hand. At first glance, the skin lines appear rough and dry, so it is called "psoriasis."
Long-term use of topical drugs may cause problems such as skin thickening, nail variation, and dandruff loss.
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