One in five psoriasis sufferers have sexual dysfunction, but new drug may help
TWO years ago, Madam Hasina Sarma, 51, withdrew from her husband of more than 20 years.
The housewife and mother of two became uncomfortable with him and rebuffed his sexual advances.
The reason? Her skin.
She has been suffering from a severe form of psoriasis for more than 20 years.
Most of the time, her condition is kept under control with medication and creams.
But whenever she is stressed, the condition flares up and large patches of her skin turn red, scaly and flaky, including her scalp, which is one of the toughest areas for her to treat.
Feeling embarrassed, she keeps her body covered up and does not leave her home.
Fortunately, that episode two years ago lasted just a couple of months before she became better. But Madam Hasina is not alone.
A recent international study showed that onein five people experienced sexual dysfunction because of psoriasis.
And more women (27.1 per cent) than men (20.8 per cent) suffer from this.
The study showed that a new drug, injected once every three months, can help sufferers.
The study showed that of the 22.4 per cent of patients who reported impaired sexual function, only 2.7 per cent reported having the problem after 12 weeks of treatment with the new drug, ustekinumab.
Madam Hasina’s skin cleared up without the need for ustekinumab, which costs $4,000 to $5,000 per injection.
She was treated with ultra-violet light and methotrexate, a prescription oral medication.
Unfortunately, her skin is starting to flare up again as she is stressed from looking after her mother,who has been hospitalised.
“There is no one to relieve me. So I feel stressed being my mother’s only caretaker,” she said.
Her husband is understanding and does not mind her condition.
Said Mr Mubarak Hussain, 48, a taxi driver: “We are still very close. But when her skin is like that, she feels shy to take off her clothes even though she knowsI don’t mind it.
“She doesn’t even want my help to apply the creams on her skin.”
Though she covers up her body, he knows when there’s a flare-up as he can feel the scaly, lumpy patches on her head.
“I play with her hair and head all the time so I know; I can feel it,”he said.
“The only bad thing for me is that when it is very bad, she doesn’t even want to leave the house.”
She used to work as a receptionist, then as a caterer’s assistant. But she had to stop work partly because of her condition.
Said Madam Hasina: “It is difficult for me to stand for long because I also have arthritis. On top of my skin problem, I have developed another problem.”
People with psoriasis are more prone to developing arthritis.
“When my skin turns scaly and red, I feel like I become something that is stuck in a shell. I can’t go out, I can’t face people,” she said.
Up to 50,000 people here suffer from psoriasis, one of the top 10 skin disorders in Singapore.
Dr Lim Kar Seng, consultant dermatologist at the National Skin Centre (NSC), said: “A recent local study revealed that 7 per cent of psoriasis patients were unemployed due to their condition. And of those who were employed, 17 per cent were missing days of work because of their psoriasis.”
The local study by Johnson & Johnson and Synovate Healthcare China polled 75 patients with moderate-to-severe psoriasis.
Dr Peter Foley, an associate professor at the University of Melbourne, spoke yesterday at a public forum called Living with Psoriasis – Local and Global Perspectives.
He said that psoriasis is more than just a skin disease.
“You can be impacted in somanydifferent ways. People can get depressed and anxious. Psoriasis is now also linked to obesity, diabetes and high blood pressure,” he said.
Hence, having enough treatment options is important for sufferers.
Treatment options include phototherapy using ultra-violet light, oral immunosuppressant drugs and creams such as topical steroid, said Dr Lim.
For those with moderate to severe psoriasis, new advances such as ustekinumab can be helpful. It has been available at NSC for about a year.
It selectively targets and blocks the action of two naturally occurring proteins in the body that are believed to contribute to the overproduction of skin cells and inflammation leading to psoriasis.
“Psoriasis is a complex disease which requires alternative treatment choices as it can become resistant to some treatments,” said Dr Lim.
The severity of psoriasis attacks varies among individuals and some may develop side effects from their current medication.
Madam Hasina is glad that she has more options now.
“It’s good to know that there are different treatments in case what I use now fails,” she said.
New drug helps improve quality of life
A STUDY on how ustekinumab helps improve the quality of life and overcome sexual difficulties of those with psoriasis involved 1,230 patients from the US and Canada. They had moderate to severe psoriasis.
The results of the study were published in the Journal of the American Academy of Dermatology in May.
Sufferers of this non-contagious skin disease are often faced with anxiety and depression.
The average scores of depression and anxiety reported by these patients are comparable to, or worse than, patients diagnosed with breast cancer.
The study also found that ustekinumab significantly improves symptoms of anxiety, depression and skin-related quality of life in patients with moderate-to-severe psoriasis, while effectively clearing the lesions.
The public forum, Living with Psoriasis – Local and Global Perspectives, organised by Psoriasis Association of Singapore, addressed issues such as living with and managing psoriasis in Singapore.
Dr Lim Kar Seng, of the National Skin Centre, and Professor Peter Foley, from Melbourne, spoke at the forum.