The blood would congeal and stick to his bedclothes.

His day didn’t improve from there. His morning shower was an ordeal because the soap would get into open wounds, causing an intense burning sensation. He slathered a topical cream all over his body and went to work wearing dark clothes; the ointment and blood would show through light clothing. When he got home, he tore off his clothes and spent the night in front of the television.

“There’s no camping, no picnics, no swimming — nothing. You don’t socialize because you’re physically uncomfortable and, to make matters worse, you look infectious,” he says. “It crushes your soul, extinguishes your desire to live.”

For almost two decades after he was diagnosed at the age of 17, Gosse, a realtor in St. John’s, Newfoundland, tried various treatments and took part in several clinical trials. Most treatments didn’t help and, with those that did, he noticed only a slight improvement. His situation seemed hopeless until eight years ago, when he started a clinical trial for a new biopharmaceutical — biologics. About four months later his symptoms were gone for the first time in his life. The married father of two has been 99 percent clear ever since. “It’s liberation,” he says.

Gosse believes that the nearly million Canadians who suffer from psoriasis can learn from his experience. “When I meet people who have the condition, I tell them there is hope. If they educate themselves about the condition, find a good doctor and experiment with treatments they will find the one that works,” he says. “But they have to be their own advocate and they have to persevere.”

Effective treatments available

Psoriasis is a chronic inflammatory condition that affects the regeneration of skin cells. Normal skin cells grow, mature and are shed as part of a natural cycle that takes about a month. But in a person with psoriasis, faulty signals in the body’s immune system trigger new skin cells to form in three to four days instead. Because the skin cells grow too quickly, they are not shed normally. Instead, they pile up on the skin’s surface, creating sores or lesions.

During a flare-up, psoriasis can be itchy and tender. Open sores may ooze tissue fluid and, on occasion, blood. Between 20 and 30 percent of patients may develop a form of arthritis that is similar to rheumatoid arthritis. Moderate to severe psoriasis may be associated with high blood pressure, leading to premature heart attack or stroke, as well as other conditions including diabetes and clinical depression. Chronic inflammation of the skin and internal organs and vessels can even reduce the patient’s life expectancy by five to ten years.

Rod Kunynetz, a physician who specializes in the treatment of psoriasis, says patients should seek treatment early on to improve their long-term prognosis. He adds that, while there is no cure for psoriasis, there are effective treatments available.

Dermatologists prescribe topical treatments as well as phototherapy, in which natural ultraviolet (UV) light from the sun and artificial UV light are used to treat the condition. In more severe cases, they turn to systemic therapies, in which medicines are taken orally or through injection — and there have been dramatic developments in this area.

Less than a decade ago, doctors and patients celebrated the arrival of biologics. Made from proteins produced by living cells instead of chemicals, biologics work by interacting with the immune system processes that cause the overproduction of skin cells and inflammation. Biologics have proven effective for Gosse and many other patients.

"Finding an effective treatment can be an arduous journey but patients who persevere and work closely with their healthcare providers are usually successful."

Finding an effective treatment can be an arduous journey but patients who persevere and work closely with their healthcare providers are usually successful. “There are many choices now,” says Kunynetz, who is an assistant dermatology professor at the University of Toronto and medical director of Ultranova Skincare Trials in Barrie, Ont. When it comes to taking aim at psoriasis, health care providers “have more bullets in our gun than ever before. If you have to have psoriasis, there has never been a better time to have it.”

Gosse, who is on the board of directors of the Canadian Psoriasis Network, also sees the value in persevering. “The change has been overwhelming,” he says, comparing his life before and after finding the right medication. “I have this tremendous sense of liberation. I appreciate my good health each and every day.”