Doctors know best, Valerie thinks. “The cream sounds good.”

Could it really be this easy? Valerie can only hope.

COULD IT
REALLY BE
THIS EASY?

it was so nice to meet you today!
same! how did your appointment go?
it went ok… he gave me a prescription cream to use but I don’t know much about psoriasis
honestly, I asked for a dermatologist referral. I want to see a skin expert since I have psoriasis too! you should, too!

How's
Valerie

?

Valerie is devastated to be diagnosed with psoriasis. Will it last forever? she wonders. It might, she thinks, since the lotion doesn’t seem to be working at all.Embarrassed by her skin and trapped in a cycle of anxiety, Valerie begins to cancel plans and stay home. She doesn’t want her friends or coworkers to see her like this.

I just want this to all go away, Valerie thinks.

CLCI

Cumulative Life Course Impairment (CLCI): Chronic diseases can exert cumulative negative impact along an individual’s life path, resulting in missed opportunities and influencing their ability to fulfill their full life potential. The negative impacts of psoriasis can be substantial.² Without appropriate management, people with psoriasis are at risk for increased CLCI.^2-4

Physical

Valerie has found her symptoms interfering with her sleep. Approximately 34% of people with psoriasis report their condition impacts their sleep.⁵

Physical

Emotional

For Valerie, hearing she had a lifelong chronic condition negatively impacted her mental health. This is one of the reasons the prevalence of depression, anxiety and suicidality is significantly greater in people with psoriasis than the general population.^20,21

Emotional

Social

People with psoriasis are frequently stigmatized and excluded from normal social environments, including schools, workplaces and swimming pools (the last place Valerie wants to be right now).^5,12 Many report experiencing loneliness, isolation, feelings of being unattractive and frustration.^5,12

Social

Economic

Valerie is worried about how her psoriasis could affect her career. Nearly 60% of people with psoriasis report missing an average of 26 days a year of work due to their psoriasis.²²

Economic

Doctor
Visit

2

Valerie is back at the doctor, and she is not happy. She explains she is experiencing more flares and itching that—along with her anxiety—is keeping her up at night. “I’m so tired all the time,” she tells him.

Doctor
Visit

2

“Your case might be more severe than I thought. I think you should see a dermatologist,” her doctor replies.

How's
Valerie

?

Valerie is upset—how much time had she wasted not seeing a specialist from the beginning? How many pounds had she gained avoiding the gym and staying isolated (and sedentary) at home?

I wish I could go back in time and request that referral earlier, she thinks. Then maybe I’d have a clue what I was doing and how I can feel like myself again.

Physical

Valerie’s weight gain could indicate a bigger issue. 71% of people with psoriasis report at least one comorbidity, and 47% report more than one.²³ These include obesity, cardiovascular disease, diabetes and depression.²²

Physical

Emotional

For Valerie, psoriasis is more than skin deep. More than 90% of people with psoriasis say their condition impacts their emotional and social life.⁵

Emotional

Social

Economic

Valerie is worried about how her psoriasis could affect her career. Nearly 60% of people with psoriasis report missing an average of 26 days a year of work due to their psoriasis.²²

Economic

Dermatologist
Visit

1

The dermatologist confirms Valerie’s first diagnosis of psoriasis and adds, “It looks like it could be a moderate case. Would you want to try a stronger cream?”

Stronger sounded better to Valerie, so she accepts. But why doesn’t she feel more confident?

hey! long time no talk
hiiiiii how’re you? how was the derm?
she gave me something to try. haven’t seen much improvement
i’m reading up on other options to manage my psoriasis
like lemon juice?
omg no!
i finally made it to a derm! still not feeling optimistic, though

How's
Valerie

?

Months go by with no improvement, and Valerie’s self-esteem drops into depression. Her partner breaks up with her after she cancels their vacation—the truth is, she didn’t want him to see the skin flakes she would shed in the bed overnight.

Valerie thinks once or twice about reaching out to her dermatologist. But the more time that goes by, the less she wants to. Nothing seems to help anyway. This is just something I need to deal with myself, she thinks.

Physical

Valerie is frustrated that she isn’t seeing progress with her current management plan. People with psoriasis tend to underestimate the amount of time a therapy can take, expecting completely clear skin in about a month.²⁵

Physical

Emotional

It’s common for people like Valerie to feel embarrassed or ashamed of their bodies.^5,12 They have an increased risk for anger, frustration, helplessness and low self-esteem.^5,12

Emotional

Social

Stigma can have long-lasting psychosocial consequences, including stress, fear of rejection, social isolation, school/work absenteeism and failed relationships, like Valerie’s latest one.^5,12,26

Social

Economic

Psoriasis is associated with high healthcare resource use and economic burden that increases with disease severity.²⁷ The longer Valerie takes to get on the right option, the higher the cost.²⁸

Economic

Dermatologist
Visit

2

“I booked this telehealth appointment because I needed to talk to you sooner,” Valerie begins. After explaining the lack of improvement in her physical symptoms, she shares she was lonely and scared. It was hard for her to even reach out, and she’s been losing touch with everyone lately.

The dermatologist nods on the screen and says there is another option she could try, one better suited for Valerie’s moderate to severe disease.

Severe? Now I have severe psoriasis? How can this get worse? She thinks as she hangs up the call.

The dermatologist nods on the screen and says there is another option she could try, one better suited for Valerie’s moderate to severe disease.

“What frustrates me the most was not knowing all the options I had for managing my disease. If I was told or learned sooner, I may not have had to wait and suffer in the process.”

_{– IFPA}

Why am I even doing all this? Valerie
thinks. Nothing’s working. My psoriasis
is just as bad as ever! I don’t know
where to go from here.

YOU
MISSED AN
APPOINTMENT!

happy holidays!
thx
how are you?
i’m ok psoriasis still flaring. at least it’s sweater weather, right?
oh no! i am on a different plan to manage my psoriasis and it’s making a real difference
you should try to see a psoriasis specialist—you need to tell them how you feel! my derm is the best, i’ll email you her info
hey, did you ever get the info i sent last week? let me know if it works out!

How's
Valerie

?

After months of withdrawal, Valerie finally makes a public appearance at her family’s annual New Year’s dinner. Her cousin pulls her aside.

“Valerie, I see you struggling. My friend with psoriasis has been seeing a dermatologist who specializes in psoriasis and says nothing but great things. She will listen to you. Please go.”

More unsolicited advice is the last thing Valerie wants. She has her doubts, but she trusts her cousin.

Physical

Valerie has found herself drinking more often, alone. The burdens of psoriasis can lead to maladaptive coping mechanisms, including increased alcohol consumption, smoking and therapy discontinuation.^3,29 In turn, this can worsen the impact of psoriasis.³⁰

Physical

Emotional

Valerie’s cousin recognizes her depression. The prevalence of depression, anxiety and suicidality is significantly greater in individuals with psoriasis, and individuals with psoriasis score lower in mental health than those with many other chronic conditions, including diabetes, arthritis and hypertension.^31,32,33

Emotional

Social

Social exclusion, discrimination and stigma can be psychologically devastating for individuals suffering from psoriasis.⁵ 70% of people with psoriasis say their disease impacts their family life—including skipping out on family gatherings, like Valerie has been.³¹

Social

Economic

Dermatologist
Visit (again)

1

Itch. Itch. Scratch. Valerie is fidgeting in the exam room.

“I see you’re itching quite a bit,” the dermatologist says. “How are your physical symptoms impacting your life?”

Valerie has never been asked that before. It is the beginning of a good conversation in which she finally says out loud that she wants to feel like her true self again. On her way out, she realizes that she finally feels heard.

How's
Valerie

?

“Psoriasis is all I think about,” she says tearfully to the dermatologist on the phone. “I am still getting flares. I’m distracted at work, wondering if my coworkers are judging me. I’m judging me. I feel like a failure.”

Her dermatologist says it is good she reached out and that Valerie should come in as soon as possible to discuss more and get to the root of her concerns. Something about this time feels different to Valerie—in a good way.

Physical

Valerie may not realize it, but seeing some physical improvement of symptoms may not be enough. Despite having almost clear skin (approximately 75% clear), individuals may continue to experience a negative impact.³⁴

Physical

Emotional

Valerie didn’t find it easy to tell her dermatologist that she wasn’t happy with her current management plan—but with more than 50% of people with psoriasis reporting dissatisfaction with their disease management plan, it’s important to speak up.³⁵

Emotional

Social

Economic

Valerie’s job has been the last thing on her mind lately. If the cumulative burden of psoriasis is managed inadequately, long-term effects include difficulty improving work prospects, reduced working capability/productivity and limited earning potential.³

Economic

Dermatologist
Visit

2

“Let’s talk about you,” her dermatologist
begins, and Valerie knows she made the
right choice in speaking up. They speak
about the impact of psoriasis on Valerie’s
life and her priorities for what needs to
improve, working together to develop
goals.

The dermatologist takes the time to
explain different options and recom-
mends one that could both help Valerie
achieve her goals and work with her
lifestyle. He enrolls Valerie in a patient
support program to get her continued,
personalized care.

valerie-dermatologist-visit-mobile-2-again

LET'S TALK
ABOUT YOU

hey lady!
hi!! sorry i never responded. it’s been really tough
but I finally have a great derm who listens
that’s so cool! i’m so happy for you
i’m still clear. i started a psoriasis instagram account haha
and I’m working as a patient ambassador to help others!
love it! look at us

How's
Valerie

?

As her skin clears, Valerie is finding her life improving in more ways than the mirror. She is beyond happy she found a good dermatologist who took the time to speak about her goals.

Even though Valerie now sees clear skin when she looks at her reflection, she will always remember what it felt like to want to hide away from the world with worry about the next time her psoriasis would flare. What opportunities did psoriasis take from her? She’ll never know—she can only move forward.

Physical

Valerie’s clear skin has been associated with greater health-related quality of life and increased satisfaction compared to almost clear skin.^34,39,40

Physical

Emotional

Valerie’s fear of losing her clear skin has a higher psychological burden now that she’s experienced it. Losing progress from clear skin can make an individual more anxious than losing progress from almost clear skin (PASI 90) to not as clear skin (PASI 75).⁴¹

Emotional

Social

Achieving clear skin can lead to improvements in the social anxiety Valerie experiences, including skin-related embarrassment, relationship problems and sexual difficulties.^34,39,40

Social

Economic

Joining a patient support program can help save Valerie money—one study showed 23% lower 12-month medical costs for those enrolled in a patient support program than those who were not.¹⁹

Economic

"So happy you’re coming to the beach day this weekend,” says Serena. “Are we more excited for the soccer game or the bonfire afterwards?"

“Actually, I can’t wait to meet everyone!” Valerie replies. “It’s my first party in a long time.”

No Two People with Psoriasis Have the Same Tale

The impact of someone’s individual psoriasis experience can touch all areas of their life—for their entire life.⁵ Because psoriasis impacts so many different parts an individual’s life, achieving disease management goals, like clear skin, could lead to an improved life path.³⁶ Timely and successful collaborative disease management between an individual and their dermatologist is needed to help limit their risk for increased CLCI—and improve their chances for a happier ending.^2-5,27

The next step is in your hands:

Get started changing your own CLCI story in psoriasis

Take a deeper dive into the CLCI of psoriasis

ALL-IMMD-210068

COULD IT REALLY BE THIS EASY?

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Social

Economic

Economic

Doctor Visit

2

Doctor Visit

2

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Economic

Economic

Dermatologist Visit

1

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Social

Economic

Economic

Dermatologist Visit

2

YOU MISSED AN APPOINTMENT!

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Social

Economic

Dermatologist Visit (again)

1

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Economic

Economic

Dermatologist Visit

2

LET'S TALK ABOUT YOU

How's Valerie

?

Physical

Physical

Emotional

Emotional

Social

Social

Economic

Economic

No Two People with Psoriasis Have the Same Tale

The next step is in your hands:

Serena’s Tale

Valerie’s Tale

COULD IT
REALLY BE
THIS EASY?

How's
Valerie

Doctor
Visit

Doctor
Visit

How's
Valerie

Dermatologist
Visit

How's
Valerie

Dermatologist
Visit

YOU
MISSED AN
APPOINTMENT!

How's
Valerie

Dermatologist
Visit (again)

How's
Valerie

Dermatologist
Visit

LET'S TALK
ABOUT YOU

How's
Valerie