Life Beyond Psoriasis: Patient Perspectives on Advancements, Advocacy, and Representation

Psoriasis is more than a chronic skin condition. It is a systemic, inflammatory disease that can impact joints, metabolism, and cardiovascular health, and it often carries heavy emotional and psychosocial burdens. Two patient advocates, Brian Lehrschall and Ayesha Patrick, recently shared their journeys with Dermatology Times, offering unique perspectives on disease management, the evolution of therapies, and the importance of community and representation.

A Lifetime With Psoriatic Disease

Lehrschall, now in his mid-forties, was diagnosed with psoriasis nearly 30 years ago. “I went from about zero to nine, more than 90% body surface coverage in about six to seven months,” he shared. His teenage years were marked by bullying over visible plaques, and in time, he also developed psoriatic arthritis (PsA). “I have tried just about every biologic you can take,” he says, recalling decades of treatment changes. Once limited to coal tar, phototherapy, and topical regimens, he has seen firsthand the dramatic expansion of systemic options, including oral therapies and biologics that address both skin and joint involvement.

But psoriatic disease does not exist in isolation. Lehrschall developed type 2 diabetes and struggled with obesity, conditions tightly linked to the systemic inflammation of psoriasis. Excess adipose tissue not only worsened his disease activity but also reduced the efficacy of systemic therapies. “There is absolutely a connection, because the more I got bullied about my psoriasis, the more I ate. The more I ate, the worse the weight got,” he explained in his story on the National Psoriasis Foundation's website.¹

A Turning Point With New Therapeutic Classes

Two years ago, Lehrschall’s blood sugar reached a critical level. His endocrinologist prescribed a glucagon-like peptide-1 (GLP-1) receptor agonist, part of a newer class of medications that regulate appetite, improve glucose control, and support weight loss. With clearance from his dermatologist, Lehrschall initiated therapy—and the results were transformative. “I’m still losing weight. Most of all, [I have] less pain," he told Dermatology Times.

Now more than 85 pounds lighter, with an A1C of 4.8, he reports not only better diabetes control but also significant improvement in his psoriasis and PsA symptoms. “I’m able to do things now that I previously wasn’t able to do,” he shares. “I go swim more. I go out and walk with more confidence.”

For him, multidisciplinary collaboration among dermatology, rheumatology, and endocrinology was critical. His experience underscores the value of treating psoriasis as a systemic disease and addressing associated comorbidities in tandem with skin and joint care.

Advocacy and Representation: A Different but Equally Vital Role

While Lehrschall’s story underscores therapeutic progress, Ayesha Patrick brings another crucial dimension to the conversation: visibility. A patient advocate, mentor with the National Psoriasis Foundation, and founder of Sistas With Psoriasis, Patrick works to elevate the voices of women of color living with the disease. Diagnosed in childhood but experiencing her most severe flare during the COVID-19 pandemic, she described the difficulty of navigating care remotely and later feeling unheard by her dermatologist. “She told me that with the medication, I had to wash my hair every day. And I said, ‘I’m a Black woman. I can’t, I don’t do that.’ She was very dismissive,” Patrick told Dermatology Times.

Patrick recently participated in the Clearly Me campaign, a collaboration between AbbVie and photographer Lindsay Adler designed to shift public perceptions of psoriasis. For Patrick, the project carried deep personal and community significance. “Especially as a Black woman living with psoriasis…many people of color are often misdiagnosed, or undiagnosed, or there’s just not a lot of information out there for people with skin of color,” she told Dermatology Times in a previous interview on the topic.²

Patrick emphasizes that psoriasis looks different on skin of color, and that clinicians must take time to understand hair and scalp care practices in diverse populations. “Every clinician should know that what we feel and experience as patients is absolutely valid,” she stressed. She also highlights the importance of listening: “Patients… really don’t feel truly heard. So if that time is taken, it would make a world of a difference”

Clinical Takeaways

Together, Lehrschall and Patrick’s narratives illustrate the multidimensional nature of psoriasis care. Lehrschall’s journey reflects how modern therapies, including biologics and newer metabolic agents, can alter the trajectory of disease and its comorbidities. Patrick’s advocacy underscores the critical need for representation, mentorship, and access to reliable information, particularly for underserved populations.

For clinicians, their stories reinforce several central imperatives:

• Integrate systemic and multidisciplinary approaches to psoriasis
• Recognize how comorbidities and lifestyle interventions shape outcomes
• Approach care with cultural awareness, particularly for patients with skin of color
• Validate patient experiences to strengthen therapeutic partnerships

Psoriasis may manifest differently in every patient, but the common thread is clear: when clinicians treat beyond the skin—both medically and personally—patients can reclaim their confidence, health, and quality of life.

References

1. National Psoriasis Foundation. Taking Back Control. July 17, 2025. Accessed August 27, 2025. https://www.psoriasis.org/advance/taking-back-control/
2. Andrus E. Ayesha Patrick: Advocacy, representation, and hope via AbbVie's clearly me campaign. May 21, 2024. Accessed August 27, 2025. https://www.dermatologytimes.com/view/ayesha-patrick-advocacy-representation-and-hope-via-abbvie-s-clearly-me-campaign