Psoriasis is a chronic skin condition characterized by inflammation. As we learn more about psoriasis, we realize this inflammation is not limited to the skin, but also extends throughout the body, thereby affecting other organ systems. This means that psoriasis patients are at risk for multiple other internal diseases.
Most importantly, chronic inflammation of the blood vessels may be increased in patients with psoriasis, and may contribute to the development atherosclerosis, or fatty plaques that form in the walls of arteries and cause blockages to develop.
Psoriasis Risk Factors
Multiple studies suggest that patients with psoriasis are at increased risk for having heart attacks and strokes, with a higher risk being associated with having more severe psoriasis. Psoriasis also appears to be associated with an increased risk of having diabetes, obesity, high blood pressure, and high cholesterol. All of these conditions are risk factors for developing cardiovascular disease.
Other diseases occur more often in patients with psoriasis. Inflammatory bowel disease, especially Crohn’s disease, is seen more frequently in psoriasis patients, as is non-alcoholic fatty liver disease. Severe psoriasis may be a risk factor for chronic kidney disease and may be associated with an increased risk of cancer, especially lymphoma. Finally, inflammation of the joints caused by psoriasis, also known as psoriatic arthritis, occurs in 6% to 42% of patients with psoriasis, with a higher risk of arthritis being seen in patients with more extensive skin disease.
People with psoriasis should be screened for the above-mentioned problems. Psoriasis patients should see their primary care physician periodically and have their blood pressure checked, as well as be screened for high cholesterol and diabetes. Smoking cessation and weight loss are also important. It has been shown that psoriasis improves when patients lose weight and smoking increases the risk of cardiovascular problems.
Some medications that are taken internally to treat psoriasis have been associated with a decrease in cardiovascular events. These medications are known as tumor necrosis factor inhibitors and are injected under the skin periodically to treat psoriasis by decreasing inflammation in the skin and throughout the body. They may also help decrease the risk of cardiovascular events in patients who use them, although they should be avoided in patients who have alcoholic liver disease. Since ultraviolet light therapy and some of the medications used internally to treat psoriasis may be associated with a higher risk of skin cancer, psoriasis patients receiving these treatments should have annual skin cancer screenings. Patients who have joint swelling, tenderness, or morning stiffness that lasts for 30 minutes or longer and improves with activity may have psoriatic arthritis and may benefit from an internal medication to treat their psoriasis and joint problems.
Get Screened for Risk Factors
If you have psoriasis, then it is important that you see your primary care physician and be screened for risk factors for cardiovascular disease such as high cholesterol, high blood pressure and diabetes. Stop smoking and lose excess weight. Be sure to tell your physicians if you have joint swelling, tenderness, and/or morning stiffness so your doctors can determine if you have psoriatic arthritis that might benefit from an internal medication. Some of these medications may not only improve your psoriasis, but also lower your risk of having a stroke or heart attack.
See a dermatologist to guide you in choosing the best psoriasis medications for your skin, joints and general health.
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol. 2017 Mar;76(3):377-390.
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017 Mar;76(3):393-403.