Psoriasis Awareness Month

For the majority of patients with psoriasis, an incurable disorder of the immune system that causes raised, red patches to appear on the skin, a visit to the doctor and a topical cream can be all it takes to clear the affected skin. But for the 20 per cent of patients who have moderate-to-severe psoriasis – sometimes covering almost their entire body – finding the best way to reduce or eliminate symptoms can be a long process. Pedro Alves, 47, has been trying different treatments to control his psoriasis for the past 20 years.

“It started when I was nineteen, with a plaque on my scalp as big as a quarter,” he explains. “I didn’t know what it was and didn’t pay too much attention to it. But then it appeared on my arms and later, all over my body. I felt uncomfortable, because people would often ask me what I had and if it was contagious. I would explain it’s not, but after a while, it became tiresome, and I started to wear long-sleeve shirts to cover it up.”

In spite of the plaques on his skin, Pedro took his condition in stride. He saw dermatologists and tried some creams, but had no clear diagnosis and no results. He was 28 years old when he first visited Dermatologist Wayne Carey at the Royal Victoria Hospital of the McGill University Health Centre (RVH-MUHC) and found out he had moderate-to severe psoriasis.

“Psoriasis can be a debilitating and socially embarrassing condition, with a significant mental and emotional impact on patients,” says Dr. Carey. “Mild psoriasis, such as a little flaking of the scalp, can be treated with topical creams, but patients with moderate-to-severe psoriasis benefit greatly from other treatments, such as ultraviolet light therapy, oral medications or biologics.”

Biologics – drugs made from living cells that target specific parts of the immune system – block certain cells and proteins that play a major role in developing psoriasis. Generally given by injection or intravenously, they get the disease under control fairly quickly. The downside to these treatments is their high cost, up to $25,000 per year. To be eligible to these agents through the Quebec Public Prescription Drug Insurance Plan or through private insurance, patients have to have tried other medications without success or with serious side effects. Some patients will participate in long-term clinical trials to have free access to biologics.

Pedro Alves, who has been taking part in studies for more than a decade, says it’s important to continue research on psoriasis, so that patients have more chances to find a treatment or a combination of treatments that work for them. He still visits Dr. Carey regularly trying different medications to keep his skin condition in control.

“It’s important to have a good relationship with your doctor,” he says. “And to keep on trying until you find a treatment that works.”