“I think the idea of improving patient care for those with autoimmune diseases is incredibly important,” – anonymous patient participant in our “Autoimmunity Voices” survey.
Our survey of autoimmune patients’ experiences revealed a common theme: the need to improve patient care. As Your Autoimmunity Connection, we share this same goal. Patient care does not just end with stepping out of the doctor’s office, so we have decided to amp up our efforts to connect patients with useful resources, and with one another.
This month, we shine our spotlight on psoriasis and psoriatic arthritis. Read on to become connected with available statistics, research initiatives, supportive patient communities, and still more resources. And check out our Facebook page and forum for more autoimmune-related updates!
What is Psoriasis?
Psoriasis is a chronic skin condition that causes cells (keratinocytes) to build up rapidly on the surface of skin, forming red patches or scales that may be itchy or even painful. Symptoms of this condition may wax and wane (stress is a known trigger), but diagnosis tends to be fairly straightforward – physicians (general practitioners and/or dermatologists) can usually diagnose psoriasis based on an examination of a patient’s skin, scalp, and nails, along with medical history. In more complicated cases, a skin biopsy may be taken to rule out other disorders. As of yet there is no cure, but treatment may calm symptoms by inhibiting the immune over-response and thus keeping skin cells from growing as quickly. Psoriasis treatments are numerous, ranging from lifestyle measures, such as moisturizing regularly, undergoing UV light therapy (“phototherapy”), and alleviating stress, which may help with symptom management, to general immunosuppressants and biological drugs that target specific immune cells.
What is Psoriatic Arthritis?
Psoriatic arthritis is an inflammatory type of arthritis that develops on average in 10-20% of patients with psoriasis, and is thought to stem from the same underlying hyperactive immune response as psoriasis. This type of arthritis can affect any joint in the body, with persistent inflammation that may lead to joint damage. Diagnosis of psoriatic arthritis is more complicated than that of psoriasis – physicians (general practitioners and/or rheumatologists) may use blood tests and X-rays, in combination with medical history, to confirm diagnoses. Although psoriatic arthritis is different from other forms of arthritis, such as osteoarthritis (not autoimmune) or rheumatoid arthritis (a major autoimmune disease), misdiagnosis sometimes occurs. The Arthritis Foundation provides tips for avoiding misdiagnosis of psoriatic arthritis as osteoarthritis, rheumatoid arthritis, or gout. If diagnosed, the good news is that treatments are available for most psoriatic arthritis patients, sometimes the same biologicals as used to treat severe psoriasis.
One complicating factor in diagnosis and treatment of psoriasis and psoriatic arthritis, is that while they have a common autoimmune etiology, patients generally present with psoriasis first. As a skin disease, the first specialist a general practitioner (GP) is likely to send psoriasis patients to is a dermatologist. Indeed, many psoriasis patients present to dermatologists first. Patients with joint symptoms are usually sent to rheumatology specialists for evaluation and diagnosis. Each specialty has different biases and preferences towards treatment because of their different focus on skin and joints. Dermatologists focus on skin symptoms and tend to be more conservative in choices of treatment. Psoriatic arthritis can be overlooked by dermatologists, especially if patients do not bring up joint symptoms. Rheumatologists tend to be more aggressive in treatment, but less sensitive to the cosmetic suffering of psoriasis patients. This is a classic case in which body-part focused medicine can be suboptimal, requiring patients to take charge of coordinating their own medical team to get the best care.
What do the numbers show?
According to the International Federation of Psoriasis Association (IFPA), approximately 3% of the world population has psoriasis. In the United States alone approximately 150,000 new cases occur each year, comprising roughly 2% of the US population.
With contributions from IFPA staff members, the World Health Organization (WHO) published a Global Report on Psoriasis in 2016. Information on psoriasis incidence, prevalence, and much more can be accessed in this report, albeit two years have now passed since its publication. This report states that between 1.3-34.7% of patients diagnosed with psoriasis are also affected by psoriatic arthritis.
With both genetic and environmental influences contributing to onset, pinpointing precise causes of psoriasis and psoriatic arthritis onset can be challenging. Whether you are affected by psoriasis, have a loved one who is affected, or are generally interested, the good news is that the recent rise in understanding from alternative approaches includes that lifestyle changes, including diet, exercise, stress management, and informed product choices, may help moderate symptoms, reduce flares, and complement or replace the need for pharmaceutical treatments.
While the IFPA, along with other leading organizations, work towards reevaluating the current state of psoriasis, our team at Your Autoimmunity Connection is connecting patients with one another and with currently available resources.
Connecting you with resources
Brush up on the basics, or dive in for a comprehensive overview
If you’ve reached this page and read this far along, chances are high that you already have at least some background knowledge about psoriasis and/or psoriatic arthritis, but it can’t hurt to brush up on the basics. The following pages each provide a comprehensive overview of psoriasis:
- Mayo Clinic: Psoriasis
- Explore all things psoriasis-related, from symptoms and causes to diagnosis and treatment, and how to choose the best doctor and department for your needs.
- Center for Disease Control & Prevention: Psoriasis
- Review the current state of diagnosis & treatment of psoriasis.
- Healthline: Psoriasis Facts and Statistics
- Recognize various types of psoriasis, possible complications, treatment options, and more.
- National Institute of Arthritis and Musculoskeletal & Skin Diseases: What is Psoriasis?
- Choose between “the basics” and an “in-depth” overview of psoriatic disease, browsing different categories from risk factors to symptoms, causes, treatments, and more.
- American Academy of Dermatology: Psoriasis Overview
- Read about the basics on your own, or watch a video of a dermatologist explaining what psoriasis is, why it develops in some cases, and how treatments may help.
Find the best specialist for your needs
- Healthline: Tips for Finding the Right Psoriasis Specialist
- Whether you are searching for a dermatologist, rheumatologist, mental health specialist, or other provider, find the right specialist to be the best “team player” for your needs.
- Psoriasis Speaks: Find a Dermatologist
- This psoriasis-focused website provides a search option that narrows by both location and types of conditions for which you are seeking treatment.
Find your patient community
- Everyday Health: Psoriasis Support Groups
- Learn how to find (or start) the right psoriasis support group for yourself.
- National Psoriasis Foundation: Talk Psoriasis Support Community
- Post your questions, read about other patients’ experiences, and access more resources to assist in managing your symptoms.
- Facebook Support Groups & Pages
- For ongoing dialogue, updates on psoriatic disease, and communication between patients from across the country or world, consider turning to online support groups & pages! A few active and engaging pages to start with include:
What’s happening in research?
We’ve picked out a few research-based pages that stood out to us. Check out the following sources to get caught up on recent findings, informed of future directions, and tap into your potential for involvement as a patient:
- National Psoriasis Foundation (NPF): Research Initiatives
- Explore NPF-funded initiatives to cure psoriatic disease and improve the lives of those affected, and learn how you can support research, too
- Science Daily: Health & Medicine – Psoriasis
- Browse the latest psoriasis-related study findings, from potential underlying causes to triggers, preventative measures, and more
- Science 37: Psoriasis Clinical Trials
- Participate in clinical trials for which you are eligible, and help advance psoriasis research
- Your Autoimmunity Connection: Monthly Newsletters
- Receive up-to-date research and guidelines focused on autoimmune diseases and care
What is one thing everyone should know about psoriatic disease?
When looking at the big picture, we must remember that psoriasis and psoriatic arthritis fall within the larger category of autoimmune diseases, of which there are over 100 individual diseases. The American Autoimmune Related Diseases Association (AARDA) estimates that 50 million Americans suffer from one or more autoimmune diseases. What’s more, a research study estimated that approximately 25% of patients with autoimmune diseases have a tendency to develop additional autoimmune diseases.1
We hope that shining the spotlight on psoriatic disease this month connects you with beneficial resources and information, but we would like to emphasize the need to take a holistic approach in tackling the autoimmune disease epidemic. By looking at all autoimmune diseases together, we can move away from the fragmented statistics that hide the magnitude of the problem and towards concerted action in reshaping research, diagnosis, and treatment. Our model is the revolution in cancer research and treatment that has come from viewing cancer as a group of diseases with common etiologies, thus garnering more resources than individual types of cancer.
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