Psoriasis Understood Your pocket guide to plaque psoriasis

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1 Psoriasis Understood Your pocket guide to plaque psoriasis Proudly supported by

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3 What is Psoriasis? Psoriasis is a common skin disorder, which affects 2.6% of Australians. It most frequently develops in young adults and continues throughout their life. The most common form of psoriasis causes raised, inflamed, scaly, red skin lesions, known as plaques. It is non-contagious, so it cannot be caught from someone else. What causes psoriasis? Psoriasis is an autoimmune disease it is caused by overactivity of the immune system in the skin. Immune cells accumulate and produce a range of chemicals, which act as if they are fighting infection or healing a wound. Skins cells multiply at an abnormally fast rate, forming psoriasis plaques. Around 30% of people with psoriasis have a family history of the condition, and inherited factors are known to be important. However, even if a person is genetically predisposed to the condition, psoriasis may not appear. A trigger is required for it to develop. These triggers or risk factors include: Smoking Alcohol consumption Infections Physical trauma Injury to the skin Certain medications Emotional stress

4 How may psoriasis affect my skin? Plaque psoriasis lesions are usually: Dry Raised slightly above the skin Red Covered with silvery scales They may also be: Itchy Inflamed Painful Cracked Bleeding There may be just a few or there may be many. They can be found anywhere on the body. Your healthcare professional will need to estimate the severity of your psoriasis in order to decide the most appropriate management strategy for you. The body surface area (BSA) affected Impact on quality of life Intensity of symptoms How much it causes disability Response to previous treatments Length of time you have had psoriasis

5 The Psoriasis Area and Severity Index (PASI) score is a rating scale for measuring the severity of psoriasis that takes into account the area coverage and plaque appearance. To calculate your PASI score, your healthcare professional will evaluate the level of redness, thickness and scaling of plaques appearing on your head, upper limbs, trunk and lower limbs. They will then assess the percentage area covered by plaques within each body region. Be sure to ask your healthcare professional what your final PASI score is. How may psoriasis affect my life? The impact of psoriasis is more than just skin deep. Due to the long-term and visual nature of psoriasis, it can have profound social, psychological and economic consequences for your life. It is critical that you are aware of these potential problems, to help you prepare for and tackle them. According to a recent survey of Australians with psoriasis: Psoriasis disrupts the social lives for one-in-two (56%) Australian sufferers

6 Relationships, marriages and family life suffer in around 45% of Australians with psoriasis General health and well-being is affected in two-thirds (66%) of Australians with psoriasis Even if psoriasis only affects a small area of your body or if your symptoms have not been officially classified as severe, it can still have a strong negative impact on your quality of life. In fact, the impact of psoriasis on quality of life is reported to be comparable with that observed in other conditions such as diabetes and depression. Possible effect of psoriasis on your life: To help you cope with your psoriasis, talk to your healthcare professional regularly about how the condition is affecting your life physically, emotionally, socially and sexually. Your healthcare professional may use a questionnaire, such as the Dermatology Life Quality Index (DLQI), to measure the impact of your psoriasis on your quality of life. You can download an example DLQI questionnaire from the Psoriasis Australia website.

7 Psoriasis affects people from all walks of life Emma Cam, model and actress, is a Miss Universe Australia finalist and winner of 2009 s Beauty and the Geek. Working in an industry focussed on beauty has never been easy for Emma - she has been living with psoriasis since the age of four. The pressure to carefully monitor her lifestyle and beauty regimen so as not to trigger a flare-up often sees her missing out on fun that most 23-year olds would take for granted. I can t go out like most people my age and have big nights, says Emma. I just can t afford to weaken my immune system, which could trigger a psoriasis attack. When I have an outbreak I have to take time out from my career, which means it sets me back from progressing with my goals. bath with oils to take away the heat from my skin. Emma also emphasises the importance of regularly visiting a dermatologist. In the majority of times, symptoms can be significantly reduced and major relief can be given, she says. Well on her way to forging a successful career, Emma is adamant to help other psoriasis sufferers overcome their demons. For years I have struggled with accepting who I am. I have missed so many opportunities because my skin condition got in the way. Having now overcome these feelings I want to share my story and make a difference. Yet there is a positive in amongst the restrictions Emma places on herself - a healthy lifestyle. Like many others with psoriasis, stress can be a major trigger for Emma s flareups, so controlling her stress levels is critical. I exercise, I eat well, get lots of rest, start small projects, write down lists of tasks, say affirmations, listen to music, spend time with people who are supportive, soak in a warm

8 What are my treatment options? There are now a number of effective treatments available for psoriasis. Doctors often take a approach with psoriasis treatment, as treatments that work well at first may lose their effectiveness over time. To read about some of these treatment options in more details, refer to the PSORIASIS CONTROLLED booklet. When considering choice of treatment, your doctor should consider the type, severity and location of your psoriasis, as well as the impact of both the disease and the treatment on your quality of life. They should also look at your perceptions of your disease and consider your hopes, expectations and goals for your treatment. TIP: Identify your treatment goals and discuss with your doctor, e.g. Achieve a PASI score of <10 Feel comfortable wearing short sleeves Reduce number of work sick days due to psoriasis flare-ups

9 How can my healthcare professional help me? Your relationship with your GP and dermatologist should be an ongoing partnership. They are best placed to help you to choose the right treatment strategy for you, so good communication is key to achieving your goals. The following tips should help you to make the most of your doctor s visits and to learn as much as you can during your limited time with them: Keep a diary that tracks how your psoriasis is effecting you, your treatment goals and effectiveness of treatment. Bring this diary to the visit so that you can refer to it as needed. Treatment diaries are available from Do not be embarrassed about asking questions! It is their job to answer them. And it s okay to say, I don t understand. Ask them to explain more clearly. Make a list of questions to discuss with your healthcare professional and bring it along to the visit. See below for some examples of questions you may like to ask. Useful questions to ask your healthcare professional: 1. What lifestyle habits may be affecting my psoriasis? 2. What are the different treatment options available and what are the benefits and side effects of each? 3. Why have you chosen this particular treatment for me? 4. Can I use other medications while I am taking this treatment? 5. How long will it take to see results? 6. How will you monitor my progress on this treatment? 7. What will happen if I stop using this treatment? 8. What resources are available to me to help me to learn about psoriasis? 9. What can I do to help me to cope with the psychological consequences of my psoriasis? 10. What can I do to help me to be more comfortable with intimacy in my relationship? 11. When will my next visit be and what can I expect?

10 Where can I get further information about psoriasis? Psoriasis Australia A source of information for all people with psoriasis and their carers. and International Federation of Psoriasis Associations (IFPA) A non-profit organisation made up of psoriasis associations from around the world. Australasian College of Dermatologists (ACD) Medical college responsible for the training and professional development of medical practitioners in the specialty of dermatology. Refer to their website to search for a dermatologist in your area and ask your GP for a referral. National Psoriasis Foundation The National Psoriasis Foundation is the largest psoriasis patient advocacy organization in the world, acting as the voice for the millions of Americans affected by psoriasis and psoriatic arthritis. Psoriasis Association The Psoriasis Association is the leading national membership organisation for people affected by psoriasis in the UK.

11 Psoriasis Australia is a not-for-profit organisation established to represent the views and needs of people with psoriasis. We aim to do this by: Promoting wellbeing for people with psoriasis by way of information provision and befriending. Empowering people with psoriasis to take control of their condition, enabling them to receive appropriate diagnosis and treatment. Facilitating ongoing social research into the physical, psychological, social and economic impact of psoriasis on the individual and society and communicating to the wider public to raise awareness. About Abbott Abbott is proud to support Psoriasis Australia and is committed to the discovery of new medicines for autoimmune diseases, as well as increasing awareness and education of the impact these diseases have on Australians. Abbott is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals and medical products, including nutritionals, devices and diagnostics. The company employs nearly 90,000 people and markets its products in more than 130 countries. Abbott employs more than 500 people in Australia and New Zealand and has offices located in Sydney, Melbourne and Wellington. Abbott s news releases and other information are available on the company s website at and

12 Disclaimer: All photographs and models used in this booklet are for illustrative purposes only, and are not listed as psoriasis sufferers.