The Impact of Psoriasis Is More Than Skin Deep

Deva Murthy

Psoriasis patient

Dr. Melinda Gooderham

Dermatologist & Medical Director, SKiN Centre for Dermatology

Chronic inflammatory autoimmune disease can affect quality of life and mental health, but new targeted therapies are bringing hope to sufferers.

When she was 11, Deva Murthy broke out in an itchy, uncomfortable rash all over her body. At age 12, she was diagnosed with severe plaque psoriasis and spent a year in hospital receiving UV light therapy and coal tar baths. The treatments would help, but after a few weeks, her plaques would return.

She remembers her mom applying ointment to her skin and wrapping her body in plastic wrap. “That was very difficult for my mom, and for me, especially being a teenager. I remember trying to cover up with makeup and clothes when my body was covered in sores,” says Murthy, 48, who lives in Long Harbour, NL. “My parents missed a lot of work taking me to doctor appointments. I missed a lot of school. Even when I did go, I couldn’t do any physical activity. It was just too uncomfortable.”

Psoriasis affects one million Canadians

Psoriasis is a chronic inflammatory autoimmune condition that affects the regeneration of skin cells. Skin cells usually grow, mature, and are shed over 28 to 30 days. With psoriasis, faulty signals in the body’s immune system trigger new skin cells to form in just three to four days. Because the skin cells grow so fast, they aren’t shed normally and pile up on the skin, creating sores, often called plaques. Thick, silvery scales form on top of these itchy and sometimes painful red patches. 

Psoriasis can also cause inflammation in other areas of the body, such as the joints or blood vessels. In about one third of cases, patients develop psoriatic arthritis, which can lead to joint pain and stiffness and if untreated, can cause deformity in the joints.

According to the Canadian Dermatology Association, psoriasis affects about one million Canadians. It can be mild, moderate, or severe, depending on how much of the body it covers, the location of the plaques, and the effects on the patient’s overall quality of life. 

Shame and depression are common

Psoriasis also carries a large emotional impact. “On its own, systemic inflammation can be associated with anxiety and depression. On top of that, you have the stigmatization of living with a visible skin disease. People who don’t understand it may think you’re contagious or withdraw from you. That exacerbates the mental burden of the condition,” says Dr. Melinda Gooderham, a dermatologist and Medical Director at the SKiN Centre for Dermatology in Peterborough, ON.

Murthy knows this all too well. “The shame of it all digs into every portion of your life. The trauma of psoriasis is very real,” she says. “I suffered from depression when I couldn’t go to school or work.”

During high school, Murthy took traditional immunosuppressants like methotrexate, which can cause harsh side effects. She and her parents were desperate for her to get some relief. In her 20s, newer medications gave her hope. Then about 13 years ago, she started biologics and has been virtually rash-free since. “My life has completely changed. The new medications are amazing,” she says. 

On its own, systemic inflammation can be associated with anxiety and depression. On top of that, you have the stigmatization of living with a visible skin disease.

Dr. Melinda Gooderham

Targeted therapies are safer and more effective

Biologics are made from proteins that are similar or the same as proteins naturally occurring in the body. They target specific parts of the immune system that are responsible for inflammation. These targeted therapies regulate the faulty signals that occur with psoriasis and are safer than medications that broadly suppress the immune system.

Dr. Gooderham says that some people may worry about receiving treatments that affect the immune system during the COVID-19 pandemic. “These newer biologic treatments are very targeted, so they aren’t suppressing the other parts of your immune system,” she says, adding that patients shouldn’t be afraid to visit their health care provider during the pandemic. She stresses that stringent safety protocols are in place in medical offices and hospitals, that there are also virtual care options, and that it’s important for patients to seek diagnosis and treatment.

Murthy wants people with moderate to severe plaque psoriasis to know that they don’t have to suffer. “You may need to try a few treatments until you find the right one for you, but there are so many options now and they’re so fabulous,” she says. “It’s easy to get depressed. It can be a dehumanizing disease. You suffer in silence for so long because you’re embarrassed. It’s important to have faith and hope and to talk about it. If you shed light on it, then the darkness goes away.”

Talk to your dermatologist or your health care professional for a referral to a dermatologist who treats psoriasis.

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To learn more about psoriasis, visit the Canadian Association of Psoriasis Patients or PsoriasisNL.

This article was made possible with support from a research-based pharmaceutical company and IMC member.