Psoriasis ended by a DIY jab… agony of The Singing Detective

Fresh start: Carol O

Fresh start: Carol O”Grady says her skin is no longer covered in red patches

It is the agonising, life-destroying skin condition that famously affected Michael Gambon’s character in the acclaimed drama The Singing Detective. And for the two million British sufferers of psoriasis, there is often little hope.

Treatment has typically involved ointments to soothe dry, cracked and scaly skin and, in more serious cases, steroid drugs to dampen inflammation. Many patients require repeated periods in hospital due to pain and infection, and there has been little that can be done to prevent relapses.

But now a breakthrough therapy involving a simple self-administered injection just four times a year is offering patients a chance to take control of the condition.

It has been approved for use in the NHS for severe cases and costs 10,000 per patient per year. Sufferers are taught how to inject themselves by a visiting nurse, but after this the patient is independent in their treatment. The drug is delivered by courier directly to the sufferer.

Psoriasis is a chronic inflammatory skin disorder that usually develops between the ages of 20 and 25. The cause of the condition is unknown. In one in three cases, there is a family history of the disease, and flare-ups are usually triggered by stress, alcohol or poor health.

When psoriasis develops, the immune system prompts the skin to renew itself much faster than normal, reducing the skin cell turnover cycle from 28 days to 48 hours. Consequently, immature cells are pushed to the surface, causing silver and red flaky, crusty patches to develop that crack easily.

Antihistamines, UV light treatment and chemotherapy are also offered to sufferers but they do not always work, can have serious side effects and usually need to be taken daily or weekly.

The new treatment, ustekinumab, belongs to a class of drugs called biologics that are designed to correct a malfunctioning immune system by targeting overactive cells or compounds in the body rather than treating the symptoms of the condition. The drug blocks the production of two chemicals in the body that act as messengers for the immune system, helping it to assess how to deal with an infection.

A study carried out by the University of Manchester and Salford Royal Hospital of patients with severe psoriasis found that more than half experienced a 75 per cent improvement after three months.

Painful: Michael Gambon as Philip Marlow and Joanne Whalley as nurse Mills from the 1986 TV mini-series The Singing Detective

Painful: Michael Gambon as Philip Marlow and Joanne Whalley as nurse Mills from the 1986 TV mini-series The Singing Detective

Carol O’Grady, 47, of Salford, was diagnosed with psoriasis in her 20s and thinks the stress of trying to conceive triggered it. Her condition meant she spent regular periods in hospital.

A sad irony of her psoriasis is that she was never able to start a family or enjoy her career as a chef. ‘The drugs I took made it impossible for me to conceive and I was retired from my job of 13 years because I didn’t look very nice,’ she says. Carol, who lives with her partner Robert Vincent, now works as a supermarket cashier.

She was offered the new treatment earlier this year and the results have been life-changing. She says: ‘I’m no longer covered in red patches, I’m not in constant pain and I’m much more confident. I don’t even think about my skin any more – the worst it ever gets is a few pink spots at the end of a three-month dose.’

Dr Richard Warren, who led the recent study, says: ‘Ustekinumab is extraordinarily effective. It’s a huge step forward for patients who have not responded to other drugs and therapies. For those most severely affected by this condition, there is significant hope for a huge improvement in quality of life.’