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Psoriasis Comorbidities: Beyond the Skin | A Woman’s Health

by Dr. C.H. Weaver M.D. Updated 12/2021

Here’s How Psoriasis Affects More Than Your Skin

What’s the first image that pops into your head when you think of psoriasis? You probably think of patches of irritated skin that are dry, scaly, and itchy. But you may not be aware that psoriasis actually has multiple comorbidities that can make living with this disease even harder.

Psoriasis is an autoimmune disorder, and while it does mainly affect the skin, it also causes chronic inflammation that can affect many different areas of the body and become detrimental to one’s overall health. We’ve compiled a list of health complications that you should look out for if you’re living with psoriasis, as well as tips to reduce the risks of developing additional health conditions.

Psoriatic Arthritis

The most common comorbidity of psoriasis is known as psoriatic arthritis. This condition causes stiff, painful joints and tendons that can lead to severe damage if left untreated. Although they are commonly seen together, psoriasis and psoriatic arthritis can exist independently of each other in a patient. Close to 30 percent of people living with psoriasis will go on to develop psoriatic arthritis, while some people may develop symptoms for arthritis before they notice any sort of plaques on their skin.

It’s possible that you can have either disease and never develop the other. However, those who are living with psoriasis should be screened for psoriatic arthritis often and should be open with their doctors if they notice any pain or stiffness in their joints.

Cardiovascular Disease

Inflammation is a natural response from the body’s immune system to fight off disease and infections. But when your immune system is malfunctioning, as it does when you have psoriasis, chronic inflammation can take a toll on your cardiovascular system. It can cause blood clots, and as a result elevate your risk of having a heart attack or stroke. If you have psoriasis and notice that you’re feeling chest pain, discomfort in your arms, shortness of breath, or lightheadedness, you should seek medical attention immediately.

Diabetes

Recent studies have shown that patients with psoriasis may also have an increased risk of developing type 2 diabetes. Diabetes is an autoimmune disease where the body is unable to regulate its blood sugar because the body is resistant to insulin. When left untreated diabetes can lead to its own set of comorbidities, including nerve damage, deteriorating eyesight, and heart failure.

Researchers are still unsure as to why psoriasis patients are more prone to develop type 2 diabetes, but it is thought to be because chronic inflammation encourages the body to release more sugar into the bloodstream and reduce insulin production. This can lead to the body becoming less sensitive to insulin over time.

Mental Health Issues

Unfortunately, psoriasis is a disease that you wear on your skin. It can sometimes be extremely visible to others, which can cause *understandable* stress, anxiety, and depression for people who are living with this condition. People with psoriasis may feel embarrassed or insecure during extreme flare-ups, which can lead to social isolation. There’s also the burden of having to deal with the chronic pain and discomfort that psoriasis can bring, which can make sometimes make it difficult to see the brighter sides of life.

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The relationship between mental health and psoriasis is a cyclical one. Stress and anxiety can trigger and worsen psoriasis flare-ups, which then perpetuates those negative feelings. If left untreated, these mental health issues can wreak havoc on your appetite and sleep schedule, making it more difficult to manage your condition. It can also lead you to find unhealthy coping mechanisms, such as smoking, drinking, poor eating habits, and self-harm. Seek the help of a therapist right away if you feel your mental health is becoming too much for you to handle alone, or if your stress and anxiety prevent you from performing your daily tasks and responsibilities.

How to Prevent Psoriasis Comorbidities

Psoriasis clearly has the ability to affect more than just your skin. Luckily, there are lifestyle changes you can make in order to reduce your risks of developing these comorbidities.

The first thing you can do is to stay on top of caring for your psoriasis. It can be easy to focus only on treating your plaques, but it’s important that you have control over your disease from the inside out. If your doctor prescribes you a biologic or steroid make sure that you take it as directed. Getting a hold of your psoriasis can greatly reduce your chances of developing an additional disease. You should also keep in touch with your primary care physician and let them know whenever something doesn’t feel right about your body. Early detection can make all the difference when dealing with these conditions.

There are also lifestyle changes you can make to reduce your risk factors for developing these diseases. Eating a healthy, well-balanced diet plays an immense role in managing your blood sugar and can lower your risk of becoming insulin resistant. It can also help keep blood pressure and cholesterol levels at a healthy rate. Pairing your healthy diet with an active lifestyle can strengthen your heart, and lower your risk for cardiovascular disease. You’ll also want to limit your alcohol intake and avoid or quit smoking to have the best chances of keeping these diseases out of your future. Prioritizing time for personal care will not only help you manage your external psoriasis symptoms and chances of developing an additional disease, but it will also help you feel well mentally.

Lastly, you should work on building a stable support system that you can lean on. This can include family, friends, medical physicians, and other people you may know who are also living with psoriasis. This will help ensure that there are people you can turn to during difficult times. It’s important to remember that life with psoriasis doesn’t have to mean your life is miserable or that you’re guaranteed to develop additional health issues. Taking care of yourself can greatly improve your quality of life.

References:

  1. Pozniak, S. (n.d.). Psoriasis Symptoms, Causes, Treatments, & More. GoodRx. https://www.goodrx.com/psoriasis
  2. Zelman, D. (n.d.). RA vs. Psoriatic Arthritis: How Do You Tell the Difference? WebMD. https://www.webmd.com/rheumatoid-arthritis/ra-and-psoriatic-arthritis-difference
  3. Jindal, S., & Jindal, N. (2018). Psoriasis and Cardiovascular Diseases: A Literature Review to Determine the Causal Relationship. Cureus. https://doi.org/10.7759/cureus.2195 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898839/
  4. Azfar, R. S., Seminara, N. M., Shin, D. B., Troxel, A. B., Margolis, D. J., & Gelfand, J. M. (2012). Increased Risk of Diabetes Mellitus and Likelihood of Receiving Diabetes Mellitus Treatment in Patients With Psoriasis. Archives of Dermatology, 148(9). https://doi.org/10.1001/archdermatol.2012.1401 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677207/
  5. Ferreira, B. I., Abreu, J. L., Reis, J. P., & Figueiredo, A. M. (2016). Psoriasis and Associated Psychiatric Disorders: A Systematic Review on Etiopathogenesis and Clinical Correlation. The Journal of clinical and aesthetic dermatology, 9(6), 36–43. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928455/
  6. Wu, B. (n.d.). Psychological effects of psoriasis. Psychological effects of psoriasis | DermNet NZ. https://dermnetnz.org/topics/psychological-effects-of-psoriasis/