Laurie Engel wakes suddenly in the middle of the night, jolted from the same recurring dream. Her hands scan her body, feeling for lesions. Relief soon replaces anxiety; it was just a dream.
Engel’s skin has been clear of psoriasis for nearly a decade, but that doesn’t keep her subconscious from conjuring the all-too-familiar sensation that her entire body is covered — and the feelings of frustration and anxiety that accompany it. “You still have those moments of fear,” says Engel, a retired Pepsi sales manager who lives near Tampa, Florida. “When you’ve been clear, you get very fearful that it’s going to come back.”
Now 62, Engel has been dealing with psoriasis for the better part of five decades. She was a teenager living in suburban Philadelphia when a doctor first diagnosed her with psoriasis of the scalp and gave her shampoo to treat the itching. “When I was 16, I really didn’t understand the impact of it,” Engel says. “It wasn’t sinking in that this was going to be my little partner for life.”
Before long, psoriasis began appearing elsewhere on Engel’s skin, ultimately covering nearly 90 percent of her body in small, round spots reminiscent of mosquito bites. From awkward explanations to early boyfriends and college roommates to self-conscious beach vacations and social gatherings, the disease has been Engel’s lifelong companion ever since. But while psoriasis has been a constant for Engel over the last several decades, treatment for the disease has changed radically during that time.
People diagnosed with psoriasis in the mid-20th century often were fortunate to get a prompt, correct diagnosis — and once they did, treatments were strictly topical and only marginally effective. Today, the treatment toolkit has grown to include topical, oral, injectable, and intravenous (IV) medications, which for many patients can yield near-total relief from psoriasis symptoms. “[Innovations in treatment have] provided patients a lot more options in terms of controlling their disease,” says Wynnis Tom, M.D., a dermatologist at Rady Children’s Hospital-San Diego. “It’s certainly helped to treat a lot more people, especially those with the severe types of psoriasis.”
For longtime psoriasis patients like Engel, each step forward in treatment has brought them one step closer to clearer skin and improved quality of life. While these medical advancements can’t erase years of physical discomfort and emotional strain, they have provided a sense of control over the disease that, in decades past, was largely unattainable. “I am so thankful for the research that has been done to provide such better options for treatment,” Engel says. “I feel strong and more in control of my psoriasis today than when I was in my 20s and 30s.”