National psoriasis survey reveals its devastating impact on quality of life

    ~ Published in Journal of Cutaneous Medicine and Surgery, SKIN survey
    contributes to a growing body of data around the world about the
    debilitating effects of psoriasis ~

    TORONTO, June 16 /CNW/ - Many of the approximately one million
Canadians(i) living with psoriasis may be faced with physical or emotional
challenges as they struggle with public misperceptions and stigmas of this
painful, chronic immune disorder that affects the skin. Now, a Leger Marketing
survey of Canadians with psoriasis, pSoriasis Knowledge IN Canada (SKIN),
reveals that the debilitating skin condition presents a substantial problem
for them in their daily lives. The SKIN survey, which included questions about
burden of illness, revealed that two-thirds (66 per cent) of SKIN respondents
agreed with the statement that psoriasis ranks among the top two illnesses in
terms of its impact on quality of life (QoL) out of ten of the worst diseases,
including cancer, heart disease, diabetes and arthritis.(1)
    Of those SKIN respondents who stated that their psoriasis "sometimes" or
"very often" caused them problems in their personal or social relationships,
and difficulties with normal daily activities when it was not in control,
almost 60 per cent indicated that their disease was a substantial
problem.(2),(ii) Previous studies show that patients with psoriasis reported a
reduction in physical and mental functioning comparable to that seen in
cancer, arthritis, hypertension, heart disease, diabetes and depression.(iii)
    Recently published online in the Journal of Cutaneous Medicine and
Surgery (JCMS), SKIN is the largest survey of its kind in Canada and
contributes to a growing body of data regarding the burden of psoriasis in
countries around the world.
    "Psoriasis can have such a significant negative impact on people's lives
- not only physically, but also emotionally and socially - but unfortunately
society often trivializes the disease," says Dr. Charles Lynde, SKIN co-author
and dermatologist, Toronto, Ontario. "Psoriasis is not cosmetic - it can be
debilitating, and for the first time, we now have published Canadian data
specific to the effects of psoriasis on quality of life. SKIN reinforces the
need for a greater recognition of the burden of illness this disease carries,
as well as more effective treatment and management."
    The SKIN survey was conducted in partnership with the Canadian Skin
Patient Alliance (CSPA), a coalition that provides psoriasis education and
information to physicians, patients and researchers. Before SKIN, published
evidence about the effects of psoriasis was lacking in Canada and these
results provide a Canadian benchmark and offer important insight into
treatment patterns.
    "The goal of the CSPA is to raise awareness about psoriasis and other
skin diseases and to ensure patients and physicians are well-informed about
the effects and optimal treatment. The results of SKIN add a new dimension to
the information available to us and we look forward to using the data to
continue to educate Canadians," says Christine Jackson, Executive Director,
Canadian Skin Patient Alliance and co-author of the SKIN publication.


    The SKIN study population was predominantly female (66 per cent). Female
respondents ranked their disease as a more serious problem than did males and
they were significantly more likely than males to say that their psoriasis had
been a substantial problem in their everyday life (41 per cent versus 24 per
    Female respondents also reported significantly greater sleep loss in
general and greater disability when psoriasis was under poor control.


    The SKIN survey reveals that half of all respondents reported that they
had developed joint pain or stiffness, but only 18 per cent of respondents had
ever received a diagnosis of psoriatic arthritis.
    Psoriatic arthritis, a condition linked to psoriasis,(v) causes swelling
and pain in and around the joints,(vi) can affect a number of joints including
the fingers, wrists, toes, knees, ankles, elbows and shoulder joints, the
spine and joints in the lower back and can also affect tissues surrounding the
joints including tendons and ligaments.(vii) Up to one-third of people with
psoriasis develop psoriatic arthritis.(viii)
    Respondents reporting no psoriatic arthritis diagnosis indicated that
they experienced stiffness in the knees, shoulders and hips (48 per cent)(ix),
followed by pain or stiffness in the finger joints (38 per cent)( x ) and toe
joints (23 per cent)(xi).


    Psoriasis is a noncontagious, lifelong chronic skin disease, which
affects approximately one million Canadians.(xii) It can strike at any age
and, in severe cases, have enormous physical and psychological effects on
    "Psoriasis is a disease that people can see but might not understand. No
one can fully appreciate what it's like to live with psoriasis unless they
suffer from it themselves," says David Smith who was diagnosed with psoriasis
at the age of 25. "Before I received treatment, I would often experience
feelings of stress and anxiety about daily activities and even going out in
public. Since starting the right treatment for my symptoms, I have a good
quality of life and I'm enjoying every minute of it."
    The most common form of psoriasis, plaque psoriasis, results when skin
cells called keratinocytes start overproducing and accumulating on the surface
to create plaques, or red patches on the skin, covered with dry, silvery
scales. It can affect the head, body, arms, legs, elbows, knees, groin and
genitals, palms and the bottoms of feet.(xiii)


    It is important for patients with psoriasis symptoms to consult a
dermatologist for a definitive diagnosis. Doctors generally treat psoriasis
based on the severity of the disease, type of psoriasis, and the patient's
attitude toward and response to initial treatments.
    Treatments for psoriasis include: topical therapies (ointments and creams
containing corticosteroids or coal tar); phototherapy (ultraviolet radiation);
and systemic therapies (methotrexate or cyclosporine) taken by pill or
    Newer biological therapies (Enbrel(R), Remicade(R), Amevive(R), Humira(R)
and Stelara(TM)) work on the body's immune system, treating psoriasis symptoms
differently than other medications, and are available to treat moderate to
severe forms of the disease. As with any medication, there is the potential
for side effects with any of these treatments, including increased risk of


    The pSoriasis Knowledge IN Canada (SKIN) survey was conducted to provide
insight into the current state of psoriasis in Canada, including number of
people affected by psoriasis, quality of life and burden of illness. The
objective of SKIN was to characterize the natural history of disease in a
sample of Canadians with a history of moderate to severe psoriasis and to
identify factors that influenced their perception of psoriasis as a problem in
their daily lives.
    Between April 30 and June 2, 2007, Canadian households were contacted by
telephone by an independent marketing research group, Leger Marketing. Target
telephone numbers were identified from a database of contact information built
from consumers requesting information about psoriasis management.
    In all, a total of 5,093(xiv) Canadian households were contacted.
Individuals who indicated that they had been diagnosed with psoriasis or
psoriatic arthritis were asked first if they considered themselves informed
about psoriasis and second if, at the height of their condition, the affected
areas of their skin would have been covered by at least 3-10 palms of their
hands. Those who answered in the affirmative were considered to have a history
of moderate to severe psoriasis and were eligible to answer the survey.
    Five hundred eligible adult Canadians were administered the SKIN survey.
Given an assumed Canadian psoriatic population of approximately one million,
it is anticipated that this sample size allows for sound and statistically
significant results with a 95 per cent confidence interval of +/-4 per cent.
SKIN was conducted in partnership with the Canadian Skin Patient Alliance
(CSPA) and supported by an unrestricted educational grant from Amgen Canada
Inc. and Wyeth Pharmaceuticals.


    Founded in 2007, the Canadian Skin Patient Alliance (CSPA) provides
education, information, an online supportive community, and opportunities to
create and join local support groups for all Canadian skin patients. CSPA is a
patient-centered organization serving patient needs to enhance care, to
promote skin health and to find cures for Canadian skin patients. CSPA also
provides physicians and researchers access to patients and their concerns
regarding skin disease. For more information, visit


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    (1) This data is not included in the published manuscript and is a survey
    (2) Answering 8, 9 or 10 on a 10-point Likert scale.


    (i)    Canadian Dermatology Association. Psoriasis.
Last Accessed June 17, 2008.
    (ii)   Journal of Cutaneous Medicine and Surgery. Online issue - June
           2009. Page 21.Table 3.
    (iii)  Rapp SR et al. Psoriasis Causes as Much Disability as other Major
           Medical Diseases J Am Acad Dermatol. 199 Sep;41 (3 pt 1):401-7.
    (iv)   Leger Gender Data.
    (v)    Arthritis Society of Canada,
    (vi)   Arthritis Society of Canada,
    (vii)  Arthritis Society of Canada,
    (viii) Canadian Skin Patient Alliance. Last
accessed August 29, 2008.
    (ix)   Journal of Cutaneous Medicine and Surgery. Online issue - June
           2009. Page 10.
    ( x )  Ibid.
    (xi)   Ibid.
    (xii)  Canadian Dermatology Association. Psoriasis.
Last Accessed June 17, 2008.
    (xiii) Ibid.
    (xiv)  Journal of Cutaneous Medicine and Surgery, Online issue - June

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