The news each day reveals more about the coronavirus and the illness it causes, COVID-19. In early June, the National Psoriasis Foundation’s COVID-19 task force released recommendations for the psoriatic community in response to the pandemic, with an update on July 7. Below, I summarize my takeaways from the recommendations and how they impact me as a person living with severe psoriasis. RELATED: A Guide to Living With Psoriasis During the COVID-19 Pandemic: Help, Resources, and Making a Personal Checklist
Recommendation: Lower Your Exposure Risk
The task force recommends practicing physical distancing, wearing face coverings in public settings when physical distancing is difficult, and washing hands regularly. Even though I feel fatigued trying to follow these recommendations month after month, I stay vigilant. Recent news suggests that COVID-19 might not go away for a while yet. So I will continue to do my best to lower my exposure risk, even if I don’t always do it perfectly. That means washing my hands regularly and moisturizing them afterward, since they become irritated or dry if I forget. I try not to touch my face, although I struggle with eczema itchiness. I regularly wear face coverings in public, although sometimes the moisture buildup irritates my face. I’m also avoiding seeing friends and family in person — the part of my pre-pandemic life that I miss the most. RELATED: Preventing Coronavirus Exposure When You Have Psoriasis and Eczema
Recommendation: Maintain Your Current Medications
A major question I had from the beginning of the coronavirus pandemic is whether I should continue taking my biologic, Skyrizi (risankizumab). While I’m not a scientist or medical professional, I understand that psoriasis stems from an overactive immune system. Since my injectable biologic works by suppressing my immune system, I reasoned that it might raise my coronavirus risk. But the task force recommends that people with psoriasis continue biologic or oral therapies. Here’s its statement: “While some uncertainties remain, initial data suggest that the benefit of continuing treatments for psoriatic diseases outweighs the hypothetical risks associated with immune-modulating treatment of poor COVID-19-related outcomes for most patients.” The task force also encourages each individual with psoriasis or psoriatic arthritis to consult with their healthcare provider, who can discuss a therapy plan while considering factors such as a patient’s age, disease characteristics, current treatments, underlying medication conditions, and personal concerns. I appreciate the task force’s acknowledgment that treatment decisions are unique for each person. To discuss my own options, I messaged my dermatologist a couple of months ago. We decided at the time, and again at my most recent telemedicine appointment, to continue my biologic therapy. Without the biologic I would be at risk for a major flare, something I would like to avoid if possible. Because I mostly stay at home and am younger than 65 — two factors that reduce my risk of coronavirus exposure and complications — my dermatologist and I decided that controlling my psoriasis outweighed any possible risk associated with my medication. I feel at peace with this treatment course, knowing I can contact my dermatologist any time to discuss changes as necessary. RELATED: Why You Shouldn’t Skip Your Dermatology Appointment During COVID-19
Recommendation: Discuss Treatment Options With Your Doctor if You Get Infected
I don’t like to think about what might happen if I become infected with COVID-19. I’d rather spend my time and energy minimizing exposure to prevent it from happening. But if I do contract the disease, I’m glad the task force addressed what to do. As with other recommendations, they advise talking to a healthcare professional about whether to stop biologic or oral therapies while infected with COVID-19. In past years, when I had a bacterial infection or the flu, my dermatologist advised me to stop any medications that affected my immune system. But with COVID-19, the situation may be different. The task force makes the point that psoriasis medications could potentially even treat COVID-19: “While it is generally advised to hold immune-modulating treatment during an infection, in the case of COVID-19, several different immune-modulating treatments used for psoriasis and other immune-mediated or autoimmune diseases are being studied in experimental placebo-controlled trials to treat or prevent severe COVID-19 illness in those infected with SARS-CoV-2.” An April 2020 article in the American Journal of Clinical Dermatology explains how this class of psoriasis medications might impact COVID-19: “Some selective immunosuppressants or immunomodulatory drugs might be useful in controlling the ‘cytokine storm’ associated with a poor outcome of COVID-19.” A cytokine storm can occur when the coronavirus pushes the immune system into overdrive, which can trigger hyperinflammation and cause potentially deadly damage to organs such as the lungs. I look forward to hearing more about this research as it unfolds. It’s fascinating to think that psoriasis medications might one day help treat COVID-19. RELATED: Scientists Fast-Track Research for Coronavirus Treatment and Vaccine
Recommendation: Consider Starting Treatment if You’re Newly Diagnosed
The task force recommends that people who are newly diagnosed with psoriatic conditions or living with untreated psoriatic disease consider initiating therapy: “Untreated psoriatic disease is associated with serious impact on physical and emotional health, and in the case of psoriatic arthritis, can lead to permanent joint damage and disability.” I know that without treatment my skin would be covered in psoriatic lesions that would lead to a lot of physical discomfort and emotional distress. The task force also notes that stress is a potential trigger for worsening psoriasis. That has been true for me. My psoriasis and eczema worsened at the beginning of the pandemic, and I have experienced some sleepless nights worrying — insomnia is another psoriasis trigger for me. Furthermore, the task force mentions that there have been “reports of psoriasis flares associated with COVID-19 illness.” These serve as additional reasons to consider seeking treatment. Of course, all of these considerations entail a conversation with your healthcare provider. RELATED: Facing My Anxieties During the Coronavirus Crisis I’m grateful for the task force’s work but am still left with my original question: Does having psoriatic disease elevate my risk of contracting the coronavirus or ending up with a worse COVID-19 outcome? The task force doesn’t seem to have an answer for me yet; I’ll keep an eye out for their next update.
