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San Francisco ? Young people with psoriasis suffer profoundly from the psychosocial aspects of the disease as well as the clinical symptoms, according to a roundtable discussion at the 64th Annual Meeting of the American Academy of Dermatology here.
"Just at the time when they're most sensitive to their peers - when they're starting to date and starting a career - they have to deal with a disease that can have a lot of impact on their lives," says Gail Zimmerman, president and CEO of the National Psoriasis Foundation.
"There's a lot of misconceptions about psoriasis," she relates. "People often think it's a disease of older people, but it typically shows up in the 15 to 25 year-old-age group. These young people need to be briefed and educated at the start in order to avoid lifelong emotional consequences."
Ms. Zimmerman says that patients with psoriasis can suffer major losses - such as losing jobs and divorces - if they don't acquire the emotional skills to deal with their disease early in life. They may suffer depression or anxiety about their condition, or may end up isolating themselves because of shame or uncomfortable physical symptoms.
Preliminary data from surveys of college students with psoriasis taken by the National Psoriasis Foundation show that 40 percent have made decisions not to participate in recreational activities, go to gym class or student events or date because of their illness, Ms. Zimmerman says.
"They've made decisions to isolate themselves."
Many young people with psoriasis have to deal with the judgments of their peers. Since so little is known about psoriasis among the general public, many people believe it's contagious.
"In high school, when 98 percent of my body was covered with psoriasis, some people told me they were afraid to be around me. I couldn't go swimming or to pool parties," says Sharma Kiesner, now a senior at the University of Hartford in Connecticut. "People did think it was contagious."
Ms. Kiesner was diagnosed at age 11, and had no response to the available medications for many years. However, she was able to find a dermatologist with an expertise in psoriasis while she was in college, and now is doing well on a biologic, which she injects three times a week.
The college student has suffered a double whammy from psoriasis: Not only does she have to contend with psoriatic plaques, but she also has psoriatic arthritis. Typically, psoriatic arthritis shows up 10 years after the development of the disease. Up to 30 percent of those with psoriasis experience psoriatic arthritis.
Not all students with psoriasis are as active or as well-adjusted as Ms. Kiesner, according to Steven Feldman, M.D., Ph.D, professor of dermatology, pathology and public health science at Wake Forest University.
"The isolation of having psoriasis can affect young people psychologically. That's why they need solid understanding and support," he says.