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Getting To Psoriasis Through The Immune System Patient Experience With Psoriasis Therapies

Psoriasis

Living With Psoriasis: Quality of Life On Treatment

Summary & Participants

Most patients with psoriasis have tried a variety of therapies to help rid them of this disturbing skin condition. Many treatment options have difficult requirements while others have problematic side effects. Listen as people living with psoriasis discuss their experiences on conventional treatments and how a new type of therapy offers new hope.

Medically Reviewed On: May 08, 2008

Webcast Transcript

NANCY BERNSTEIN: I didn't think it was a big deal when I first found out I had psoriasis. I thought it was something you just can put some creams on and it would go away, and that would be the end of it. I didn't realize how much of a struggle I would have to go through to actually clear up.

ANNOUNCER: Psoriasis sufferer Nancy Bernstein isn't alone. Between six to seven million Americans suffer from this chronic immune system disease that results in an unsightly, itchy and often painful skin condition.

BRIAN BALLESIO: I think the most difficult part about growing up with psoriasis is the peer pressure: people not understanding what psoriasis is, and people making a judgment before they know what it is.

ANNOUNCER: Currently there are a variety of treatment options and deciding which is best depends on many factors. Determining how active the disease is at the time is important.

PAUL YAMAUCHI, MD: Acute outbreak is when a patient's psoriasis, when it was previously stable, all of a sudden it flares up, and it covers a larger percentage of their body surface area.

ANNOUNCER: The severity of the psoriasis also influences the treatment.

JERRY BAGEL, MD: Topical creams could be used in the treatment of mild psoriasis. But for moderate psoriasis, the absorption and the time of application would make them pretty much useless.

ANNOUNCER: For moderate to severe psoriasis, which affects over 10% of the body, there are other options. PUVA or light therapy can be effective, but it takes a real investment of time for the patient.

PAUL YAMAUCHI, MD: They do get remission for several weeks or several months after discontinuing the light therapy. The downside to light therapy is the increased incidence or risk of skin cancer, and also premature aging of the skin.

You have to do it two or three times a week, every week, so patients have to take time off from their work schedule to come into a doctor's office, get the light therapy done and then go back to work again. So it can be inconvenient if a person has a busy lifestyle.

ANNOUNCER: Medications like methotrexate and cyclosporin are effective, and taken easily in pill form, but they can pose certain problems.

JERRY BAGEL, MD: With methotrexate in particular, there is liver damage that can occur. In addition, there's also risks on the lungs and on the white count. It works pretty well, but it usually doesn't clear patients completely either.

The kidney toxicity is the major fault of cyclosporin. Although it does work, it takes about six to eight weeks to kick in. Different people will tolerate different medications, depending upon their past medical history.

ANNOUNCER: Recently a new kind of treatment called biologics has been added to the options.

PAUL YAMAUCHI, MD: The advantages of these biologic agents are that they have less side effects, much safer than the systemic agents. No incidence any kind of liver or kidney damage. And they're usually administered as shots.

ANNOUNCER: In some cases, after treatment with biologics, patients can be in remission for months, even without being on treatment. The degree of response matters, and of course it differs for everyone. But in deciding on treatment doctors also work with patients to factor in what best suits the way they live.

PAUL YAMAUCHI, MD: If a person has a very busy lifestyle that they cannot come in, let's say, two to three times a week for light therapy, then I might consider doing either systemic agents, where they take pills at home, or do the biologic agents. Now that we have these biological agents, which are safer, my inclination would be to try to put them on these biologic agents first as a line of therapy.

ANNOUNCER: Biologics have worked well for patients like Nancy and Brian.

BRIAN BALLESIO: I'd really held back on my personal life, on where I wanted to go and what I wanted to do for a very long time, not feeling secure about myself. And once the psoriasis went away, I went gung-ho. I went after anything I wanted to, whether it be professional, dating, personal, whatever it was.

ANNOUNCER: In the end, effective treatment can make all the difference in the life of a person with psoriasis.

NANCY BERNSTEIN: It makes such a big difference in the way you feel about yourself; you're not worrying about what people are staring at and thinking. But you know that they're focusing on you and who you are, and not your psoriasis.