Talking Psoriasis with Caridee English and Dr. Kassabian

May 12, 2017 Providence Guest Blogger

Psoriasis is a very common condition, affecting more than 7.5 million people in the United States. It can develop at any age and starts with red, scaly patches on the skin in very noticeable places such as the hands, elbows, knees, and even on the face.

It can make life very challenging for many people and is often mistaken for a contagious rash, causing frustration for those with the condition.

We sat down with two experts to help you better understand the topic.  First, we chatted with CariDee English, a professional model, actress, and winner of "America's Top Model" television show. She was diagnosed with psoriasis as a child and grew up dealing with the insecurities and pain that stem from the auto-immune disease.

How long have you had psoriasis?

Most of my life, I was diagnosed at the age of five.

Since Psoriasis is often hereditary, do other people in your family suffer from it, did you know what it was and what to expect?

My mother has psoriasis! I got her long legs and her skin. Lol. She never had it as bad as mine. Mine was severe, covering 80% of my body. It shaped the woman I am today. I was insecure on the inside, yet super bubbly on the outside, so people would never know.

You are a spokesperson for the National Psoriasis Foundation, what made you want to be so vocal about it?

I always felt alone. I saw all the other girls with their good skin and then the boys that didn't want to get near me. I wanted to show the world what psoriasis is, what it means. Because with knowledge, it erases fear. If I had someone to look up to when I was a kid, it really would have helped. That's what I am trying to do now.

What kind of treatments have you tried for your condition and what has worked the best?

I have tried a bit of everything. There is no cure. The best thing you can do is have a dermatologist and work with them to find what works for you. You can learn more about your disease and get information from the National Psoriasis Foundation website.

Why is having a close relationship with your dermatologist important?

Having that relationship with your dermatologist is critical, as you'll need to work with them a lot. It's also important to have a relationship with your psoriasis too. The relationship you build with your doctor and your disease is symbiotic, and one that is a life-long relationship.

Did you have any issues securing employment as a model with your condition?

There are many factors involved in getting a job in the modeling world. I've had many instances where the psoriasis scarring goes to my head. When you don't get picked, you sometimes hear why, but not every time.

What made you decide to do a modeling shoot when you had your psoriasis flare up?

I wanted the world to know what it looks like when you have psoriasis. I did it for the little girls and boys who are too afraid to live their life despite psoriasis. I always have this desire to scream to the world "I have psoriasis but psoriasis does not have me. This shoot was my way of asking others out there to do the same.

Many people with psoriasis are more prone to depression, have you ever suffered from depression due to your condition?

Of course. Being different, in terms of having a disease, is depressing. Rejection is depressing. However, taking control of yourself and letting your pain have a purpose is incredibly powerful. It was my way of taking control back.

What advice would you give young people living with psoriasis?

Roll up your sleeves. Have a great relationship with a doctor and yourself. Find online and offline support. Love yourself. Go out in the sun. Fight psoriasis, not yourself.

Dr. Carolyn Kassabian, talks about managing the symptoms of Psoriasis

Next, we chatted with Carolyn M. Kassabian, MD, a dermatologist at Providence Holy Cross Medical Center. We asked Dr. Kassabian to provide people with more information about Psoriasis.

What is psoriasis?

Psoriasis is a skin condition where patients get red, scaly patches of skin most commonly on their scalp, elbows, and knees, although any part of the skin can be involved.

How common is psoriasis?

Psoriasis occurs in both genders equally. It is found in about 3.6% of Caucasians compared to 1.9% of African Americans.

What is the primary cause?

We don't know the exact cause of psoriasis, but we do know that is related to the immune system and genetics. Most commonly a patient will have a blood relative that has or had psoriasis. Bacterial infections, such as strep throat, can cause flare-ups. Other factors that may exacerbate the condition include dry skin, stress and certain medications.

Is it contagious?

No, psoriasis is not contagious. If two family members have the disease, it is because they have similar genes.

When does it present?

Psoriasis most commonly presents between the age of 15 and 35, but it can develop at any age including childhood and later in life.

Are there any symptoms?

Yes, most commonly patients report that the red, scaly patches of skin itch and flake. Some psoriasis plaques can even sting or burn.

Is each case different?

Yes, there are many various presentations of psoriasis. The most common form involves red and scaly well- demarcated plaques. Others can get small round dot-like rashes, or red patches in their folds, or even pus-filled blisters. Some patients only have involvement of one body area while others have a more widespread distribution.

What are the treatments?

Although we do not have a cure for psoriasis just yet, many treatment options can help improve the signs and symptoms. Moisturizers, over-the-counter and prescription steroid creams and shampoos are commonly used to treat milder cases. If psoriasis covers large portions of the body, your doctor may prescribe light therapy (also known as phototherapy), or oral medications such as methotrexate or a newer medication called Otezla. Lastly, biologic medications are also an option for moderate to severe disease. These are injections that usually a patient self-administers at home. All medications have potential side effects, and the risks and benefits of these medications need to be discussed with your dermatologist before starting treatment.

Why is it important to have a close patient-doctor relationship?

Building a good relationship between patient and doctor starts with diagnosing the condition. Secondly, a thorough discussion of the treatment options is vital to establishing trust. Sometimes patients have a relatively small body surface area involved, but if the areas involved are visible to other people, it may be negatively affecting the patient's quality of life. The patient may choose to have a more aggressive treatment. For this reason, it is critical to have a good communication between the patient and doctor.

To learn more about psoriasis, check out some of these articles

Sorting Out the Facts About Psoriasis »
Healing Psoriasis with Precision Drugs »
Is inflammation related to chronic disease? »
Is psoriasis getting under your skin? »

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