Psoriasis The Silent Disease That Can Damage More Than Your Skin

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FOR years, a 43-year-old man struggled with psoriasis so severe that thick plaques covered his scalp, face, trunk, and limbs. Ashamed and hopeless, he shut himself indoors and avoided social contact.
His turning point came when a friend living with psoriasis encouraged him to seek help from Dr Wong Kit Wan, Consultant Dermatologist at Dr Amy Wong Skin Specialist Clinic and Sessional Consultant Dermatologist at KPJ Pasir Gudang Specialist Hospital.
After starting biologic treatment, his skin cleared completely. A year later, he has not only regained his confidence but is now pursuing a master’s degree in engineering.
Stories like his, said Dr Wong, reveal how psoriasis can affect every aspect of a person’s life. Yet many still dismiss it as a minor or purely cosmetic condition.
Misconceptions persist that psoriasis is contagious, linked to poor hygiene, or caused by allergies. These beliefs stigmatise patients and delay proper treatment.
“The truth is, psoriasis is a chronic autoimmune disease driven by the immune system, not by dirt or infection,” Dr Wong explained.
“It arises from a mix of genetic and environmental triggers such as stress, infection, smoking, certain medications and alcohol. It is not contagious and not caused by poor hygiene.”
Psoriasis in Malaysia

“According to Global Psoriasis Atlas, psoriasis affects between 0.2% and 2.5% of the population. In Malaysia, prevalence is lower at about 0.34%, and significantly below the 3–4.6%,” Dr Wong noted.
“We tend to see psoriasis peak in two age groups, adults in their 20s and 30s, and again between 50 and 60. From my clinical experience, Indian patients appear more frequently affected compared to Chinese and Malays.”
The hidden danger of psoriatic arthritis
While psoriasis is often thought of as a skin-only problem, up to 20–30% of patients may develop psoriatic arthritis (PsA), a form of inflammatory arthritis linked to psoriasis.
“Psoriatic arthritis can cause joint pain, swelling and stiffness. In about 70–80% of cases, the skin symptoms appear first, with arthritis developing several years later,” Dr Wong explained.
“The risk is often overlooked because symptoms can be non-specific and sometimes patients do not report them. It can also be misdiagnosed as other forms of arthritis and in some cases, inflammation may occur without symptoms at all.”
Early warning signs include joint pain, stiffness or swelling that is worse in the morning or after inactivity. Patients may also present with back pain or heel pain. Nail changes such as pitting, thickening, discolouration or crumbling can also signal the risk of PsA.
“Joint damage can occur quickly, in some cases within two years of diagnosis. Once joint damage has occurred, it cannot be reversed. That is why early diagnosis and treatment are so important,” Dr Wong cautioned.
Psoriasis is beyond the physical
Psoriasis takes a toll not only on the body but also on mental health.
“Having psoriasis increases the risk of depression and anxiety. Patients often feel socially isolated because of the visibility of their condition and this affects their emotional wellbeing, confidence and productivity,” Dr Wong remarked.
“Joining support groups such as the Psoriasis Association of Malaysia and educating friends and family about the non-contagious nature of psoriasis can help. Professional support is also important if symptoms of depression or anxiety are present.”
Breakthroughs in psoriasis care
The good news is that treatment for psoriasis has advanced dramatically in recent years.
“For mild psoriasis, topical treatment such as steroid, coal tar and Vitamin D analogues can be used,” Dr Wong explained.
“In moderate to severe cases, and in those affecting high-impact areas such as the scalp, face, hands, feet, nails, genital areas or skin folds, other options include phototherapy, oral medications such as methotrexate, retinoids or cyclosporin, and biologics.”
Biologics, she noted, are targeted therapies that interrupt specific immune pathways causing inflammation, unlike older medicines that broadly suppress the immune system.
(Image: Shutterstock)“They are safe for long-term use. Side effects are very rare,” she added.
Cost can be a concern, but access has improved.
“There are patient assistance programmes available for biologics which make these treatments more affordable for patients today,” Dr Wong explains.
She stresses that treatment decisions should be made collaboratively.
“The treatment plan is a shared decision between doctor and patient, taking into account the severity of the disease, the sites involved and how the patient has responded to previous treatment.
“Lifestyle changes such as weight management, stress reduction and stopping smoking or alcohol are also important.”
Equally critical is regular follow-up. “Even if symptoms are under control, patients must continue regular check-ups. Psoriasis is a chronic, lifelong, and unpredictable inflammatory disease that can flare again.
“Follow-up ensures maintenance, medication adjustments, and monitoring for side effects or associated conditions,” Dr Wong advised.
A message to Malaysians
“Even though there is no cure for psoriasis, it is very treatable and controllable today with advanced therapies such as biologics,” Dr Wong continued.
“Living with psoriasis means being part of a strong, supportive community where one can find hope and effective treatment.
“Work with your dermatologist to find a treatment plan that suits you, and remember to prioritise self-care and overall wellbeing. You are not alone!” ‒  Focus Malaysia

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