If you don’t live with it yourself, I am pretty sure you probably know someone who has the skin condition, psoriasis. I personally know a couple of people and in my career as a nurse, I helped care for many people who were living with psoriasis.
If you are unfamiliar with this condition:
- Psoriasis is an inflammatory condition characterized by lesions, which are areas of inflamed skin where the cells grow too fast. This creates red, scaly, thick patches of skin (called “plaques”). Psoriasis comes in different forms. The most common form is psoriasis vulgaris, also referred to as plaque psoriasis. The exact cause of psoriasis is not known.
- People living with psoriasis can experience elevated levels of stress and feelings of isolation, and in some cases, psoriasis can lead to depression.
- Flare-ups can be triggered by many factors including cold weather, stress, nutrition, exercise and skin care.
- There are an estimated one million Canadians living with psoriasis. While it can develop at any age, it is typically seen in adults and occurs equally among men and women and in all ethnic groups. A leading risk factor for the condition is genetics.
Psoriasis affects more than just your skin.
New global report shows (un)happiness for Canadians with psoriasis is prevalent and driven by loneliness and stress.
Depending on the areas of your body affected by this disease, you can well imagine the patient’s potential for social isolation and depression.
In fact, a recent report, the first-ever World Psoriasis Happiness Report, shows (un)happiness for Canadians with psoriasis is prevalent and driven by loneliness and stress. Even though Canada ranks 5th out of 19 countries for psoriasis happiness, Canadians with psoriasis are not “pso” happy.
Psoriasis is impacting Canadians’ happiness. Based on the 2017 United Nations Happiness Report, the average Canadian rates their happiness at a 7.3/10. However, this indicates a “happiness gap,” as respondents to the 2017 World Psoriasis Happiness Report only rate themselves at a 6.1/10 – a full 17% less than a Canadian who does not suffer from psoriasis.
The psoriasis report, which was produced by the Happiness Research Institute, in partnership with LEO Innovation Lab, an independent unit of LEO Pharma, provides an analysis of findings from online surveys completed by more than 120,000 people in more than 100 countries who live with psoriasis. Conducted with the support of The Canadian Association of Psoriasis Patients (CAPP) in Canada, the survey includes more than 2,250 respondents from Canada.
- Advances in psoriasis treatment and access to these treatments is critical for improving happiness in people living with psoriasis.
What many people don’t know is that psoriasis is highly treatable. Topical treatments are formulations applied directly on the skin, which most patients receive at the beginning of their treatment journey. Some patients also use systemic or biologic therapy.
- Taking control of this chronic disease can help people take control of their own happiness.
- Many psoriasis patients are living untreated. Psoriasis is a chronic condition that requires continuous condition management, not just flare management.
- According to the World Psoriasis Happiness Report, more than half (56%) of Canadian respondents don’t think they’ve been informed by their health care provider about the different treatment options.
- People living with psoriasis need to seek optimal care: Primary care physicians, pharmacists, and dermatologists can often help by developing a plan so patients can actively manage their psoriasis, using the latest treatments and management tools available.
I recently had the opportunity to speak with dermatologist, Dr. Sonya Abdulla, and ask her a few psoriasis related questions. She is extremely knowledgeable and was very happy to answer all my questions. I have added the transcript of our conversation below. I hope you take a few minutes to read the interview, it was quite fascinating.
My interview with Dr. Sonya Abdulla —
Monica: For someone who doesn’t know much about what psoriasis is, can you please describe it and what it’s like to live with the condition?
Dr. Abdulla: Psoriasis is a chronic inflammatory condition of the skin that tends to affect areas like the elbows, knees, and scalp. Because it is a chronic condition, it is usually a lifelong disease. In terms of skin involvement, patients tend to develop thickening of the areas previously mentioned with some redness and skin buildup. That can be aesthetically a concern to patients. But psoriasis can also be physically uncomfortable as it can involve dryness, itching, cracking and sometimes even bleeding of these areas. As a result, the condition affects patients emotionally and physically.
Monica: If you have psoriasis, what are some things you can do to manage flare-ups?
Dr. Abdulla: Psoriasis does tend to ebb and flow with flare-ups. There are parts of the year when the skin is less active and less inflamed and there are a number of triggers that can activate psoriasis. It may be things like seasonal change or cold dry weather, stress (a common trigger) and in some patients, psoriasis (particularly what we refer to as guttate psoriasis) can be triggered by a strep throat infection. These are the three of the most common triggers for psoriasis.
Addressing psoriasis from a preventative strategy is best. With the cold, dry weather upon us, remember to use gentle soap and regular moisturizer. If you’re a psoriasis patient who’s stressed, trying to leave a well-rounded and balanced lifestyle, along with addressing some of those particularly stressful triggers, can be helpful.
If you are prone to getting strep throat, there is some data to suggest that treating strep throat in the context of guttate psoriasis and flare-ups can be helpful.
Beyond all that, it’s important for psoriasis patients to make sure they have access to medications. This usually involves prescription medications in the form of topical steroids along with a combination of topical steroids and vitamin D analogues which tend to be the most common strategies. We can always move to other strategies including light treatment, treatment by mouth like methotrexate or even biologic medication.
Monica: It’s good to know that there are many treatment strategies out there. In terms of the new global Psoriasis Happiness Report that was just released by LEO in partnership with the Happiness Research Institute – what did it find?
Dr. Abdulla: Overall, it found that the degree of happiness of people with psoriasis was less than we anticipated. This demonstrates the emotional impact that psoriasis can have on an individual. We know that with psoriasis there are varying degrees of involvement. And patients with more severe forms of the disease tend to have a lower happiness score.
Monica: Were you surprised with the results?
Dr. Abdulla: I can’t say I was surprised to see the results but it was eye-opening to see the specific things that were asked of patients because we’re not always apt to ask about feelings of social isolation and quality of life. But I think it really emphasizes the need to bring the topics to the forefront and have open and honest discussion with our patients. And these are emotional things that aren’t always easy to discuss but opening the door to patients can be helpful.
Monica: I was going to ask why you thought the results were important but I think you answered that! While the symptoms are physical, it seems like psoriasis has a significant impact under the skin as well. What can we do to support Canadians living with the disease, both emotionally and physically?
Dr. Abdulla: The biggest thing is open and honest communication. We need to encourage both patients and physicians to tap into the emotional aspect of psoriasis. That is an important part of managing any type of chronic condition, whether it’s related to the skin or otherwise, and recognizing the impact it can have on a patient’s quality of life. Beyond that, I think it’s always important to make sure that a correct diagnosis is made and treatment options are discussed.
Monica: Does everyone that has psoriasis know that they have psoriasis? Are they sometimes thinking that it’s just eczema or itchy skin?
Dr. Abdulla: The best way to confirm the diagnosis is to see your dermatologist. This is often done clinically because psoriasis does have a classic appearance. Sometimes a skin biopsy is required to confirm the diagnosis. As for patients that know they have psoriasis, it’s usually because the diagnosis has been confirmed. However, there are a number of patients in Canada and worldwide who are living with psoriasis without having been diagnosed. Often times, there are people living with limited symptoms that they attribute to dandruff or eczema but it is actually psoriasis.
Monica: What would you tell someone who’s just been diagnosed with psoriasis?
Dr. Abdulla: I think it’s important that patients understand that they’re not alone. As dermatologists, we are there as your ally to help you find the most appropriate and effective treatment options for you and your lifestyle. It’s also important for patients to realize that there are a number of treatment options. And even if we have one that may not respond to your needs, we’re fortunate that we have multiple to choose from.
Monica: Why do you think so many people with psoriasis are living untreated?
Dr. Abdulla: I think there is a number of factors, including under-diagnosis or even misdiagnosis. The majority of psoriasis patients have mild to moderate forms of the disease which is treated with topical medication. Patients need to commit to ongoing treatment. There are a number of things that can be challenging but once you commit to a treatment regiment and start to see the improvement, that’s really when people tend to be more committed.
Monica: Is there anything you’d like to share on the topic I may have missed?
Dr. Abdulla: Psoriasis is a chronic inflammatory condition of the skin but it also has other associated conditions including inflammation of the joints that we refer to as psoriatic arthritis. There are data that show the association between psoriasis and increased incidents of metabolic syndromes like obesity, high cholesterol, high blood pressure, high blood sugar, etc. as well as inflammatory bowel disease like Crohn’s disease.
Monica: Thank you so much, Dr. Abdulla!
Dr. Abdulla: Thank you, Monica!
Biography – Dr. Sonya Abdulla
Dr. Sonya Abdulla is a board-certified dermatologist in Canada and the US with additional Fellowship training in Dermatologic Laser Surgery and Aesthetic Medicine from the University of Toronto. She earned her Doctor of Medicine degree from the University of Ottawa, earning the Dr. André Peloquin Award for excellence in patient care.
Dr. Abdulla is a published author with articles in peer-reviewed scientific journals, an active medical student and resident teacher at the University of Toronto, and a member of the Canadian Dermatology Association, American Academy of Dermatology, American Society of Dermatologic Surgery, Ontario Medical Association and Canadian Medical Association.
Disclosure: This post is sponsored in partnership with LEO Pharma Canada. As always, all opinions are our own.