On the occasion of Psoriasis Awareness Week 2021, which ran from October 29 to November 4, we spoke with Dominic Urmston, Patient Advocacy and Communications Manager of UK-based charity The Psoriasis Association. Below please find insights into the work of the charity, novel treatments options for psoriasis as well as the organisation’s schedule for the awareness event.

Please tell us more about The Psoriasis Association and the work of the charity.

The Psoriasis Association is the leading national charity and membership organisation for people affected by psoriasis in the UK. We have three main objectives: to provide information, advice and support to those whose lives are affected by psoriasis; to raise awareness of psoriasis; and to promote and fund research into the causes, nature and care of psoriasis.

In accordance with these three main objectives, what is The Psoriasis Association currently doing to: i) support people with psoriasis; ii) raise awareness of psoriasis; iii) research psoriasis?

We provide easy access to accurate, up-to-date and evidence-based information about psoriasis, psoriatic arthritis and treatments. This is offered through our website, and social media channels: Facebook, Twitter, Instagram, LinkedIn and YouTube. We also maintain a dedicated helpline service by phone, email and WhatsApp and provide leaflets and information sheets to people with psoriasis and healthcare professionals free of charge. The forums on our website and our Facebook Group are safe spaces where people with psoriasis can share their experiences and find peer-to-peer support.

Our annual Psoriasis Awareness Week begins on 29th October (World Psoriasis Day), and we also raise awareness of psoriasis at events, meetings and exhibitions attended by our members, the general public, healthcare professionals and politicians. We provide leaflets and posters to hospitals, clinics and surgeries, and regularly speak at conferences to healthcare professionals on issues that really matter to patients. We support and sit on a number of parliamentary groups in order to ensure that the voices of people with psoriasis are heard in the English and Scottish Parliaments, and the National Assembly for Wales.

Through our annual research programme we award grants to high-quality projects. We also collaborate with various research studies and consortia to ensure that the voices of people with psoriasis and psoriatic arthritis are heard. We use our communities to help researchers both recruit participants to their studies and communicate their findings.

What is the difference between psoriasis and psoriatic arthritis, and who is primarily affected?

Psoriasis is an immune condition which causes symptoms on the skin. The skin replacement process speeds up, taking just a few days to replace cells that usually take 21–28 days. This accumulation of skin cells builds up to form raised “plaques” on the skin, which can be flaky, scaly, itchy, and red on Caucasian skin or dark on darker skin tones. Psoriasis can occur on any area of the body.

Psoriatic arthritis is an inflammatory arthritis which affects around 1 in 5 people with psoriasis. It affects the joints (such as the knees or those in the hands and feet), as well as areas where tendons join to bone (such as the heel and lower back), causing tenderness, swelling and stiffness.

Most people who have psoriatic arthritis find it occurs after developing psoriasis, but some do develop the arthritis before they notice any psoriasis on their skin. Men and women are equally likely to develop psoriatic arthritis and, although it can occur at any age, it is most common in the first decade after being diagnosed with psoriasis. Psoriatic arthritis is not always linked to how severe a person’s psoriasis is. People with mild or moderate psoriasis can also develop psoriatic arthritis.

Which novel treatment options for psoriasis are on the horizon?

Since 2006 there have been great treatment advances for people with severe psoriasis or active psoriatic arthritis in the form of “biologics”. Biologics are mostly given by injection and are specifically designed to mimic chemicals that are naturally found within the human body. These biologic medications block or neutralise the activity of certain chemical “messengers” in the immune system which signal other cells to cause inflammation. By blocking this activity, these biologics are blocking the very mechanisms that lead to the over-production of skin cells and symptoms of psoriasis or the damage to bones and tendons in psoriatic arthritis.

A new treatment class for psoriatic arthritis, Janus kinase (JAK) inhibitors, has also been approved for use, with research ongoing in psoriasis. JAK inhibitors are mostly taken orally as tablets and work by blocking the messaging pathway, calming down the immune system and easing the symptoms.

With these exciting advances, research is now underway to make it possible to predict which biologic will work best for different individuals, thereby improving on the current “trial and error” approach to finding an effective treatment.

Psoteen is your sister website for teenagers and young people with psoriasis. To which extent is psoriasis different in this group?

Guttate psoriasis is particularly common in teenagers and young adults. This presents as a widespread rash of small spots that appear mainly across the torso, back, limbs and sometimes neck, head and scalp. Guttate psoriasis often begins after a throat infection and usually clears after several weeks or months.

The most common form of psoriasis, plaque psoriasis, has two distinct points of onset, often between the ages of 16–22 years and 55–60 years. It is vital that young people have relevant information and support at a time when they are often experiencing a number of changes and challenges alongside psoriasis (for instance exams, relationships, and moving out of home).

Psoriasis of any kind impacts day-to-day life. The visible nature of psoriasis can be particularly tough to deal with and can lead to feelings of shame and embarrassment, low self-esteem and social isolation.

Psoriasis Awareness Week 2021 ran from Friday 29th October to Thursday 4th November, with a theme focusing on lifestyle factors. What were your plans for this year’s awareness week?

This Psoriasis Awareness Week we held two Facebook Live sessions with experts in nutrition and exercise. The first examined the evidence for nutrition in psoriasis. The second focused on the benefits of exercise for psoriasis and psoriatic arthritis.

We also collaborated with St John’s Derm Academy in London to hold an online webinar. This event included updates on two major psoriasis research projects – The PsoProtectMe psoriasis and COVID-19 registry and the Biomarkers and Stratification To Optimise outcomes in Psoriasis (BSTOP) study which aims to identify biomarkers that will enable doctors to give the right psoriasis medicine to the right patient at the right time.

Finally, Psoriasis Awareness Week also sees the launch of our fundraising challenge – the #PsoActive29. Its aim is for participants to raise vital funds and awareness whilst improving their own health and wellbeing by taking on an active challenge.

More information about Psoriasis Awareness Week and the #PsoActive29 can be found on our website.

Many thanks for your time and for the interview.