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COVID-19 is an illness that can affect your lungs and airways. It is caused by a new type of coronavirus known as SARS-COV-2. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.

People can catch COVID-19 from other people who have the virus (human-to-human transmission) through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Others then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in the droplets from a person with COVID-19 who coughs out or exhales droplets. This usually happens at a distance of 1 meter or less.

The WHO is assessing the transmission routes of COVID-19, and updating its conclusions. For the latest findings visit: https://bit.ly/3fzqJ1L

There is currently no evidence that people with psoriatic disease are any more or less likely to catch COVID-19. You should follow the same precautions recommended by the World Health Organization and your local health authorities to protect yourself and others.

Clinicians and health care providers are aware of the concerns about COVID-19 and treatment. The current available advice takes special consideration for people living with Pso/PsA on biologics who are confirmed to have COVID-19. Individual risk can vary and should be assessed by your health care provider. Factors include which systemic medications you are taking, whether you are taking more than one of these medications, and whether you are living with co-morbidities or other medical issues. If you have questions about your treatment, contact your care provider. Whenever possible, use the phone or another telehealth tool to access health services from a distance to reduce the risk of infection.

At this time, we do not advise that you make any changes to your treatment as a preventative measure or without consulting your prescriber. If you experience symptoms of COVID-19 (such as fever, persistent coughing, loss of smell and taste, or other common symptoms), consult your psoriatic disease care provider to discuss whether or not you should continue your systemic treatment.  

Please see the International Psoriasis Council guidance to clinicians which is in accordance with established treatment guidelines and advises clinicians to stop biologic therapy for people living with Pso/PsA confirmed to have COVID-19.

References:

Dermatologists BA of. Dermatology Advice Regarding Self-Isolation and Immunosuppressed Patients: Adults, Paediatrics and Young People [Internet]. 2020. Available from: http://www.bad.org.uk/healthca...

American Academy of Dermatology. Managing your practice through the COVID-19 outbreak [Internet]. 2020. Available from: https://www.aad.org/member/pra...

Forum ED. Statement on the Coronavirus (COVID-19) Outbreak [Internet]. 2020. Available from: https://www.edf.one/home.html

EADV TF, SPIN. Recommendation from the EADV Psoriatic disease Task Force / SPIN [Internet]. 17-04-2020. p. 1–2. Available from: https://www.eadv.org/cms-admin... DISEASE-SPIN TF Recommandations_Covid-Corner.pdf

WHO provides excellent advice on masks. Masks should be worn as part of a comprehensive strategy to limit spread of COVID-19. However, use of masks should be coupled with other preventive measures such a physical distancing, frequent hand washing, and avoiding touching of face and mask.

The situation is different for every context. Current advice for testing depends on the stage of the outbreak in the country or area where you live. Testing approaches will be adapted to the situation at national and local level. Stay up to date with your national/ local health authorities testing approach.

It is recommended to wash hands using soap and water very thoroughly. This may be difficult but the dermatology association recommends it as a practical approach. Regular handwashing is one of the best ways to protect yourself and your family from getting sick.

To learn more about handwashing, visit the World Health Organization’s website on clean hands protection against infection.

For great tips on washing hands with sensitive skin, watch the video from the Psoriasis and Eczema Association of Norway!

• In discussion with your provider you share concerns with regards to treatment.

• Your dermatologist is aware of the current developments and advice on effects of COVID-19 from their guidelines on care & treatment of people living with psoriatic disease

• When you do contact your healthcare provider, it is best to use the phone or another telehealth solution whenever possible to reduce the risk of infection. Ask your healthcare provider for suggestions when you book your appointment.

Contact your health care provider with any urgent questions. Health systems are experiencing a high load right now, and as the situation progresses remember that your dermatologist may also be seeing other members of the psoriatic disease community who are in need of immediate care. Contact your health care provider only when necessary with specific questions. One way to support the medical community is to practice the simple measures of prevention to keep yourself safe. Remember to take advantage of phone appointments and other telehealth solutions whenever possible to reduce the risk of infection.

Stay aware of the latest information. In line with the general public health guidance regarding COVID-19, we continue to encourage you to refer to your local health authorities following guidance from WHO (CDC). Follow the DO THE FIVE CAMPAIGN launched by WHO.

Remember to do the FIVE:

1. HANDS: Wash them often with soap
2. ELBOW: Cough or sneeze into elbow if you must
3. FACE: Do not touch your face, mouth or eyes
4. SPACE: Practice “social distancing” by keeping a safe distance more than one meter (3ft) apart.
5. HOME: Are you sick? Are any of your family members sick? If you can, please stay home and call your healthcare provider. If you believe you have been exposed to COVID-19, contact your healthcare provider as well as your dermatologist via telephone.

References:

World Health Organization. Coronavirus disease (COVID-19) advice for the public [Internet]. 2020. Available from: https://www.who.int/emergencie...

Centers for Disease Control and Prevention. Coronavirus (COVID-19). 2020; Available from: https://www.cdc.gov/coronaviru...

European Centre for Disease Prevention and Control. Q & A on COVID-19 [Internet]. 2020. Available from: https://www.ecdc.europa.eu/en/...

Current advice from the International Psoriasis Council, European Academy of Dermatology and Venereology, and Skin Inflammation & Psoriasis International Network recognize that individuals aged 60 years and older as well as people living with certain psoriatic disease co-morbidities – diabetes, hypertension, cardiovascular disease, chronic lung disease, asthma, hepatitis B, chronic kidney diseases, and cancer  and obesity – have a higher risk of complication if infected by SARS-CoV-2. Links to more information on this subject are upcoming.

References:

Council IP. IPC -Statement on the Coronavirus (COVID-19) Outbreak [Internet]. 2020. Available from: https://www.psoriatic diseasecouncil.org/blog/...

Dermatologists BA of. Dermatology Advice Regarding Self-Isolation and Immunosuppressed Patients: Adults, Paediatrics and Young People [Internet]. 2020. Available from: http://www.bad.org.uk/healthca...

The arrival of COVID-19 vaccines is cause for optimism. For people with psoriatic disease, vaccines may also raise questions. Review IFPA's full advice about vaccines.

In many cases, people receiving drugs that affect the immune system are advised to avoid live vaccines. The vaccines currently being administered for COVID-19 are non-live vaccines. In general, non-live vaccines can be given safely to people receiving drugs that affect the immune system. Current recommendations including guidance from the International Psoriasis Council (IPC) advises physicians and other health practitioners to administer COVID-19 vaccines to people with psoriatic disease unless they have specific contraindication to vaccination. Further studies are required to understand the effectiveness of COVID-19 vaccines in people who take medications that affect the immune system. The decision to be vaccinated should be an individual one, shared between you and your physician.

There is currently no evidence that COVID-19 vaccines have any effect on the severity of psoriatic disease. Further studies will reveal whether COVID-19 vaccines can worsen or improve symptoms of psoriatic disease. While there is currently no evidence that vaccines have an effect on symptoms, we recommend that decision making takes place together with your healthcare provider.

Any licensed vaccine must be tested rigorously before approval and assessed regularly after being introduced. Most of the COVID-19 vaccines in development are non-live vaccines (like mRNA vaccines) that do not use the live virus that causes COVID-19. Generally, non-live vaccines are safe for people who take medications that affect the immune system. Check with your health care provider to make sure you do not have any contraindications or allergies to ingredients in the vaccine.

There is still not enough evidence to predict how effective COVID-19 vaccines will be for people who take medication that affects the immune system. As COVID-19 vaccines become available, registries will collect information to give us a better understanding of their effectiveness in people taking drugs that affect the immune system.

You can stop misinformation and educate your peers. Check out this useful tool from EDU Med for helpful tips to talk about vaccines.

How to talk about vaccines

Skin manifestations of psoriatic disease can be of different types – plaque, inverse, guttate, pustular and erythrodermic – and have different characteristics.

Psoriatic disease can affect any joint, tendon or ligament, causing pain, stiffness, and swelling.

Yes. There are six main types of psoriasis of the skin, each with their own characteristics. It is important to remember that no type of psoriasis is ever contagious.

• Plaque psoriasis

About 80% of people with psoriasis have plaque psoriasis. It often occurs on your elbows, knees, back or head as thick, red, inflamed patches. Silvery, flaking scales are also a symptom of plaque psoriasis.

• Inverse psoriasis

Most commonly occurs in skin folds, such as your armpits, groin area, buttocks or under your breasts. In contrast to plaque psoriasis, the red lesions caused by inverse psoriasis are smooth and shiny.

• Guttate psoriasis

Occurs most frequently in children or adolescents. It causes tiny pink spots on your upper body, arms and legs. The spots are often thinner than the thick patches common in plaque psoriasis.

• Pustular psoriasis

Causes white pus blisters and red skin. Pustular psoriasis can cover your entire body or it can be limited to specific areas like your hand palms or foot soles. It mostly affects adults.

• Erythrodermic psoriasis

A severe, highly inflammatory type of psoriasis. Erythrodermic psoriasis can cause fiery red skin across your entire body, with skin scales falling off in sheets.

• Palmoplantar psoriasis

Affects your handpalms or footsoles. Palmoplantar psoriasis can cause scaly plaques, general thickening of the skin and deep, painful cracks and dryness. This can make it difficult to walk or use your hands.

Researchers are not yet sure what the exact cause of psoriasis is. However, various factors could play a role:

• Genetics
  Psoriasis can run in families genetically: up to a third of people with psoriasis report having a relative with psoriasis. Research also shows that 10% of the population may carry a gene that makes them more likely to develop psoriasis. However, only 2-3% of them will eventually get psoriasis.

• External factors
  Several external factors could “trigger” psoriasis to develop. These factors vary from person to person, so something that causes your psoriasis may leave someone else unaffected. Possible triggers include: stress, infection (like strep throat), skin injury (cuts, scratches, bug bites, sunburn) and medication (including lithium, indomethacin, quinidine).

• Immune system
  Psoriasis appears to be closely related to how our immune system works. Normally, it takes 28 to 30 days for our bodies to develop new skin cells and shed the old. When you have psoriasis however, your immune system becomes overactive. It then produces new skin cells extremely fast, in less than 7 days. This means that your old skin cells pile up on top of each other. The result are the symptoms of psoriasis: inflamed skin, thick red patches and a constant flaking of old skin cells.

IFPA actively encourages scientific research into the disease. Discovering what causes psoriasis could vastly improve treatment or even help to find a cure one day.

It is estimated that at least 60 million people have psoriatic disease worldwide.

No, psoriatic disease is not contagious. Because you cannot catch psoriatic disease from someone else, there is no need at all to avoid people with psoriatic disease – you can hug them, hang out with them, go swimming, borrow each other’s clothes, hold their hand, have fun together, … just like with anyone else!

No, not yet. Psoriatic disease is a chronic illness and often requires lifelong treatment.

Yes, there appears to be a link with other conditions. When you have two or more diseases at the same time, these are called “comorbidities.” People with psoriatic disease have a higher risk of developing these comorbid conditions:

• Cardiovascular disease (heart disease)
• Type 2 diabetes
• Metabolic syndrome
• Liver disease
• High blood pressure (hypertension)
• Crohn’s disease
• Ulcerative colitis
• High cholesterol
• Depression
• Psoriatic arthritis

Because these conditions can shorten your lifespan, it is very important to tell your doctor about any symptoms you have. This can help you prevent, monitor and treat comorbidities. Together with your doctor you can find the proper treatment or medication for your conditions.

A disease Atlas is a database organized by geographic zones. It provides updated data about a disease or set of diseases.

This includes the prevalence (the total number of people living with the disease at any one point) and the incidence ( the number of people who are diagnosed with psoriasis in a specific time period). A disease atlas can also include other data such as mortality, risk factors, hospitalizations, research, HC systems measures, and more.

The World Health Organization Resolution WHA67.9 requested that WHO publish a global report on psoriasis, including the global incidence and prevalence, emphasizing the need for further research on psoriasis. The Global Psoriasis Atlas responds to this call and aims to map the global burden of psoriasis using the highest scientific standards. This research will ultimately ensure that people living with psoriasis have the best available care, wherever they live.

The mission of the GPA is to "provide the common benchmark on the complete burden of psoriasis in all countries and regions throughout the world.”

The GPA is a long-term project, driving continuous improvement in the understanding of psoriasis. The study explores how psoriasis affects both the individual and society at large.

The GPA consists of

• Board of Governors
• Scientific Advisory Board
• Steering Committee
• Collaboration Team
• Research and Management Team at the University of Manchester
   

The GPA is a collaboration of three leading organizations: IFPA, the International League of Dermatological Societies (ILDS) and the International Psoriasis Council (IPC), the Collaboration Team.

The GPA is the world’s most extensive review of the global burden of psoriasis and provides open access information about the worldwide epidemiology of psoriasis. The GPA’s research includes incidence and prevalence of psoriasis, access to care and comorbidities along with other specific research objectives detailed on their website.  

The Global Psoriasis Atlas can be used as:

• An advocacy tool
• A source for citations in media and scientific publications
• A source of accurate data for messaging and materials
• A tool of to compare the burden of psoriasis across regions and countries.

A rare disease is any disease that affects a small percentage of the population.

An orphan disease is a rare disease whose rarity means there is a lack of a market large enough to gain support and resources for discovering treatments - so support is given by governments.

About 3 percent of people living with psoriasis develop pustular psoriasis. This includes Generalized Pustular Psoriasis (GPP) when pustules occur all over the body, and Palmo-plantar Pustular Psoriasis (PPP) when pustules occur on the hands and feet.

Erythrodermic psoriasis is another severe, life-threatening, and rare form of psoriasis characterized by fiery red skin across the entire body, increased heart rate, severe itching, and change in body temperature.

Finally, arthritis mutilans is a severe, deforming type of psoriatic arthritis that affects less than 5% of people living with PsA. Arthritis mutilans has been associated with pustular psoriasis.

Learn more about Generalized Pustular Psoriasis in the portal for rare diseases and orphan drugs.