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Psoriasis to vitiligo—Autoimmune skin diseases can be stressful. Here is what you can do

Discuss with your doctor how to best take high-potency topical steroids, and try not to continue applying them beyond three weeks at a stretch.

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Skin being the largest organ of the human body holds the mirror to our internal health. Any disruption in the normal functioning of our organs reflects on our skin first. This includes diseases that seem ‘invisible’ to the eye — autoimmune disorders that can target your skin too.

An autoimmune disease pertains to a condition in which the immune system is unable to differentiate between the body’s own tissues and foreign cells. Such dysregulation leads to the production of antibodies (proteins that protect you from foreign objects such as bacteria and viruses) that attack the body’s own tissues, including skin cells. This can lead to various interrelated conditions of the skin and hair, which can predate one another. Scleroderma, psoriasis, vitiligo, and skin lupus are common conditions.

Although the aetiology of these diseases remains elusive, it is known for certain that biochemical, genetic, and environmental factors can trigger autoantibody formation and disease initiation. Other factors such as stress, smoking, and weak immunity can flare up diseases too. While it is not proven yet, pollution is also touted to be a trigger for autoimmune diseases.

Globally, there has been a steady rise in autoimmune skin diseases in the last decade. According to the World Psoriasis Day consortium, psoriasis afflicts 2-3 per cent of the world population, and various studies estimate that vitiligo and pemphigus affect approximately 0.5-2 per cent.

In South Asia, the incidences of autoimmune skin diseases are highest in India. The Indian Journal of Medical Research states that psoriasis effects nearly 0.44-2.8 per cent of the population in the country. Vitiligo is observed among 0.25-4 per cent of Indians.

New findings suggest that patients with dermatomyositis (a condition marked by skin rash and muscle weakness) experienced an exacerbation of symptoms after taking the Covid vaccine. Patients with lupus were less affected after being fully vaccinated.

However, clinicians should encourage all patients to get vaccinated against Covid, including ones with autoimmune diseases. Below are some measures that such patients can adopt to lead a healthier, happier lifestyle.

Also read: Don’t fall for extensive skin care during winter. Fix dryness, dullness with these steps

Tips to lead a healthier lifestyle

It is important to understand what your autoimmune condition entails. Do your research and speak to your doctor and friends in the medical community to know how you can tackle your symptoms.

Autoimmune skin diseases can be mentally stressful for patients, especially if the condition shows on exposed areas of the body such as the face or limbs. Unfortunately, the stigma attached to such conditions worsens it; stress can flare up the symptoms by triggering more antibody production. Therefore, self-counselling is as important as medical treatment.

Know that most autoimmune skin disorders are lifelong diseases but not life-limiting. An attitude change toward your condition can improve the quality of life. Accepting your condition, practising self-love, and speaking up to family and friends can help.

Dietary antioxidants are mandatory for all autoimmune disease patients and those who are at risk — mostly due to their family history and genetics. Include more fruits and vegetables such as cranberries, peaches and red, yellow, and green bell peppers in your diet to keep symptoms at bay.

Anti-inflammatory steroids can be taken orally for up to two weeks if the patient is non-diabetic. Alternatively, oral mini-pulse therapy lasting for 2-3 days can work over a period of a few months. But these treatments are prescribed only in cases of serious flare-ups of symptoms. You must include calcium in your diet by consuming moringa, dark green leafy vegetables, soybean, and figs.

Discuss with your doctor how to best take high-potency topical steroids, and try not to continue applying them beyond three weeks at a stretch. It’s a good idea to switch to lower potency steroids and take gaps.

For patients with autoimmune skin diseases, allium-containing substances — tomato, onion, garlic, mango, pepper, and non-steroidal anti-inflammatory painkillers — are a strict no. At least avoid such foods in salads and fresh forms.

Lastly, as a dermatologist, I say with certainty that most skin diseases, especially autoimmune disorders, are impacted by one’s mental well-being and environment. A healthy lifestyle and positive attitude are the medicines one needs most.

Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.

(Edited by Humra Laeeq)

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