Dermatologist are specialist doctors. Psoriatic disease with visible skin involvement will require specialist care by dermatologist. Dermatologist may practice in large hospitals or operate from a private specialist clinic. We advise psoriatic patients to seek treatment from dermatologist who are registered with the The Dermatological Society of Malaysia. Please visit their website here.

Rheumatologist are specialist doctors. Psoriatic disease patients who experince the following symptoms should inform your primary care or specialist doctor, and decide to see a rheumatologist.

• Fatigue

• Tenderness, pain and swelling over tendons

• Swollen fingers and toes that sometimes resemble sausages

• Stiffness, pain, throbbing, swelling and tenderness in one or more joints

• Reduced range of motion

• Morning stiffness and tiredness

• Nail changes, such as pitting or separation from the nail bed

• Redness and pain of the eye (uveitis)

Please visit the Malaysian Society Of Rheumatology website to see a list of hospitals with rheumatology services.

Primary care physicians or general practitioners (Known as GP doctors) most often, form the first point of contact for patients who seek treatment when they develop a rash, regardless of whether it is psoriasis or not.

Such physicians can also help to monitor patient's comorbidities associated with psoriasis such as hypertension, diabetes, cardiovascular disease and other associated illnesses.

A primary care physician may refer a patient to a dermatologist.

Payment for the treatment of Psoriasis falls into the following categories:

OUT OF POCKET EXPENSES This is where the payment of treatment is paid by the patient. The association’s estimation is that treatment for Psoriatic disease (depending on the severity), can cost between a few hundred ringgit to RM 50,000 per year. For patients who wish to pursue biologics as their treatment, the cost is estimated to range between RM30,000 - 50,000 per year.

Costs for treatment at the following health providers include:

Public Hospital – doctor’s consultation is at minimal cost. Selected medicines are free to the Malaysian public (example: selected topical creams). Patients may not be able to select certain treatments. This could be due to availability or the high costs (example biologic treatments) Private Hospital or Private Clinic – doctor’s consultation cost and treatment costs are paid via patient’s out of pocket expenses. Patients can discuss with their doctors on the available treatments for psoriatic disease (as long as the patient can afford the treatment).

OTHER POSSIBLE SOURCES TO FUND YOUR TREATMENT

EPF - For Psoriatic Arthritis patients, you are eligible to withdraw monies from your EPF account as PsA is classified as a serious disease. To know more, click here. We advise that you familiarise yourself with the procedures and enquire with the relevant EPF staff due to the many forms and supporting documents that are required. Not completing the forms properly or missing information required, may result in delays during the application process. Company medical benefits – Employees may have medical benefits and depending on their employer medical benefits, can make a financial claim for their Psoriatic disease treatments. Please check with your Human Resources department for more information.

Tabung Bantuan Perubatan (Medical Assistance Fund) provided by Ministry of Health less fortunate Malaysians to partially finance or the full cost of treatment. The fund primarily caters to the B40 segment. There are conditions that need to be fulfilled before the patient is eligible. To know more, click here or enquire with a doctor at the government hospital. We advise that you familiarise yourself with the procedures for the above because very often when a patient is referred to a medical social worker, a patient may not bring the necessary documents like household bills, etc. This will add to further delay in the process. Last updated: 202203

The related illnesses or "Comorbidities" as they are termed, can develop because of the underlying psoriatic condtion. Please discuss the following with your doctor and get yourself screened if you are unwell.

Cardiovascular Disease

Cardiovascular disease (also known as heart disease) refers to numerous conditions including heart attack, stroke, heart failure, arrythmia (irregular heart rhythm) and heart valve problems.

Metabolic Syndrome

Metabolic syndrome refers to the presence of increased blood pressure, high blood sugar, excess body fat and abnormal cholesterol levels, which increase the risk of heart disease, stroke and type 2 diabetes.

Obesity

Obesity is a complex chronic disease involving genetic and environmental factors. Obesity is defined as too much body fat (especially around the waist) that presents a health risk. Obesity may increase the risk of chronic diseases such as cardiovascular disease, diabetes and cancer. Body Mass Index (BMI) uses a person’s height and weight to determine obesity. A person with a BMI of 30 or more is generally considered to have obesity.

Hypertension

Hypertension is another name for high blood pressure, which refers to the pressure of blood pushing against the walls of the arteries. Hypertension is very common and increases the risk for cardiovascular disease and stroke.

Dyslipidemia

Dyslipidemia refers to the consistent high levels of cholesterol and other lipids (also called fats) in the blood. Dyslipidemia may increase risk of cardiovascular disease.

Diabetes

Type 2 diabetes (also called insulin resistance) refers to cells in the body that do not respond normally to insulin. Normally insulin works to let blood sugar into the cells in the body to use as energy. Type 2 diabetes may increase the risk of cardiovascular disease, vision loss and kidney disease.

Anxiety and Depression

People with anxiety disorders often struggle with intense feelings of anxiety, worry, fear and/or panic. Anxiety can interfere with daily activities and may last a long time. People with depression experience a persistent sad mood that lasts a long time and interferes with daily activities.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to conditions characterized by inflammation in the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.

Cancer

Cancer describes diseases in which abnormal cells divide without control and may spread into nearby tissue. There are more than 100 types of cancers and are often named after the area in the body where the cancer forms.

Kidney Disease

Chronic kidney disease occurs when the kidneys are damaged or cannot filter blood as well as normal kidneys. As a result, extra fluid and waste from the blood stay in the body and may lead to other health problems.

Sleep Apnea

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. This happens when the muscles in the throat relax, blocking the airway.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease refers to a group of diseases that cause breathing-related problems and airflow blockage.

Uveitis

Uveitis refers to inflammation in the eye which affects the middle layer of tissue in the eye wall (uvea). Symptoms include eye redness, pain and blurred vision and symptoms may come on suddenly and progress quickly.

Hepatic (liver) Disease

Hepatic disease refers to inflammation of the liver that disrupts the liver’s function and which can lead to permanent kidney damage.

Source: https://www.psoriasis.org/related-conditions/

• Topical treatment (Cream, ointment and gel)

• Photo Therapy

• Oral medications (Methotrexate, Acitretin, Cyclosporin)

• Biologics injection

There is no cure for psoriasis. Psoriasis treatments can improve your condition and newer treatments can control symptoms very well. Last Updated: 202203

• Methotrexate

• Sulfasalazine

• Leflunomide

• Cyclosporin

• Biologics

• JAK Inhibitors

There is no cure for Psoriatic Arthritis. Treatments can improve your condition and newer treatments can control symptoms very well.

Last updated 202203

An accurate and early diagnosis of psoriatic arthritis will help you avoid the damage and deformity it can cause.

Your doctor will make a decision based on:

• Your symptoms

• A physical exam

• Your medical history and your family's medical history

• Lab tests (to give clues or rule out other forms of arthritis)

No single thing will diagnose psoriatic arthritis, but blood tests, imaging, and other tests can help your doctor. They may want to give you certain tests that check for rheumatoid arthritis, because it can look a lot like psoriatic arthritis.

Along with your symptoms, the most telling signs are the skin and nail changes you get with psoriasis. Imaging procedures such as X-rays or MRI may be used by the rheumatologist to further help with the diagnosis. As a patient, you have the right to request your rheumatologist to proceed with the imaging processes. Please educate yourself on the costs of these imaging processes especially if you self paying.

Scientist and medical professional are currently working to discover a specific Psoriatic Arthritis biomarker. We hope this will be found soon.

PAM advocates for using medicine that is approved by the NPRA (National Pharmaceutical Regulatory Agency). You may perform a product search online at NPRA. To know how to identify medicine that is registered with the Ministry of Health, click here.