Prejudice that ‘skin diseases are mild’ requires improvement in treatment environment [아픔 나누기, 그리고 희망]
“I had suicidal thoughts from the time I was 10 until I was in my 30s. “I was always embarrassed, felt ashamed of myself, and had no expectations of interpersonal relationships.”
Mr. Oh, an office worker in his 50s, has suffered from psoriasis his entire life since he was 6 years old. He emphasized that the constant cost of treatment and the attention of others are factors that tire patients, as are the lesions that occur on the skin. Mr. Oh emphasized, “Psoriasis is not a disease caused by dirt, and it is not contagious.”
According to the medical community on the 31st, psoriasis patients agree that social attention is needed to improve the treatment environment. Although psoriasis does not take lives, patients experience a serious decline in quality of life and financial burden. Psoriasis requires lifelong treatment, and there are many cases in which it is accompanied by mental illness and requires consultation with a psychiatrist. A change in social awareness of the disease and empathy for patients are also needed.
When psoriasis develops, red rashes, inflammation, and dead skin cells repeatedly appear on the skin. Although the exact cause has not been revealed, genetic, environmental factors, skin irritation, and stress are considered triggers. Arthritis may also occur due to immune system abnormalities. Skin symptoms repeatedly improve and worsen throughout life, so continuous treatment and medication are required.
Mr. Oh complained, “I have severe psoriasis on my nails and toenails due to a long-term illness, and the risk of developing arthritis is high, so I am always worried.” He also said, “The psychological stress continues throughout my life.”
Psoriasis is considered a disease with a high burden of disease due to the large number of young patients. This is because skin lesions that occur on exposed areas such as the face, arms, and legs can hinder social and economic activities.
According to the Health Insurance Review and Assessment Service’s statistics on diseases of national interest, the number of psoriasis patients in Korea decreased from 164,438 in 2018 to 154,399 in 2022. However, looking at the age of patients, those in their 50s ranked first and second with 32,794 people and those in their 40s with 30,666 people, respectively. There are quite a few patients in their 20s and 30s who are looking for work or are new to society, at 17,555 and 24,362, respectively.
Mr. Oh said, “When I was in school, I couldn’t do a physical exam or take off my clothes during physical education class. “He had no expectations of interpersonal relationships, such as marriage.”
Mr. Kim, a 53-year-old office worker who has suffered from psoriasis since he was 7 years old, said, “It is difficult to receive attention from others because psoriasis is accompanied by pain, itchiness, and dead skin cells.” “It’s uncomfortable,” he complained.
Since it is a disease that requires lifelong treatment, the financial burden is also significant. Since July 2017, special health insurance calculation provisions have been applied only to patients with severe psoriasis, but not many patients receive the benefits. There are six types of biologics for psoriasis and psoriatic arthritis approved in Korea, including adalimumab, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab. To be recognized for health insurance benefits, symptoms must persist for more than 6 months and there must be skin lesions covering more than 10% of the body.
Mr. Oh explained, “If you want to use biological products without health insurance coverage, you have to pay for the drug well over 10 million won a year,” adding, “Before the special calculation system came out, I couldn’t dare.” Mr. Kim also said, “It is difficult because I always have to manage not only psoriasis, but also joint diseases, high blood pressure, and hyperlipidemia that accompany it.”
The social perception that all dermatological diseases are mild causes patients to become more discouraged. Recently, the essential medical policy package has been discussed with a focus on serious and emergency diseases and the so-called avoidable diseases, and the sense of alienation felt by psoriasis patients has grown even more.
Mr. Kim said, “Psoriasis causes patients lifelong pain to the extent that it is called a ‘disease that eats away life.’ He expressed regret, saying, “There are patients who do not receive special calculation benefits and suffer economic losses after being misled by indiscriminate dermatology treatment,” adding, “I feel that people with dermatological diseases are discriminated against compared to other diseases.”
Mr. Oh said, “We need to eliminate prejudice against diseases and patients through school education, and increase access to effective treatment such as biological agents and marine healing experience auxiliary therapy,” adding, “This is impossible through the patient’s individual efforts or economic power.” He urged government support.