Snapshot: Conditions Associated with Psoriasis

Psoriasis is a chronic, immune-mediated inflammatory disease affecting the skin. Most cases of psoriasis can be controlled, and most people who have psoriasis live regular lives.

Sometimes, having a chronic systemic illness may increase the likelihood of developing other chronic conditions. Psoriasis is unfortunately known to be associated with a higher risk of developing certain associated chronic illnesses, or comorbidities.

Psoriatic Arthritis

Psoriatic arthritis (PA), the inflammation of joints and connective tissue, may develop in up to 30% of patients with psoriasis. While PA mainly affects larger joints and distal joints, the symptoms vary from person to person. Presentation ranges from mild and occasional flares to continuous joint pain. PA has the potential to cause a significant impact on day-to-day function. Because of this, it is important to get PA diagnosed early to prevent further damage to the joints. More information can be found here.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a broad term describing chronic inflammation of the digestive tract and includes forms such as Crohn’s disease and ulcerative colitis. Like psoriasis, IBD is also linked to a maladaptive immune system response as the cause of bowel inflammation. Patients with psoriasis may be at three-times higher risk of developing IBD compared to the general population.

Uveitis

Uveitis is the inflammation of the eye, and in patients with psoriasis, uveitis is likely immune-mediated. Around 40% of uveitis cases are caused by, or secondary to, an existing immune-mediated disease such as psoriasis. Symptoms arise depending on the portion of the eye involved and may impact one or both eyes. Warning signs include eye redness, pain, or blurry vision and should be promptly assessed by an ophthalmologist. With a diagnosis of uveitis, treatment can be given to reduce inflammation and prevent vision loss.

Cardiovascular Disease

Cardiovascular diseases (CVD) includes conditions such as stroke, coronary artery disease, and deep vein thrombosis, which are all caused by pathologies in the heart and blood vessels. Although psoriasis is linked to an increased risk or aggravation of CVD, early detection and simple interventions such as lifestyle improvements and pharmacological aid (if needed) are extremely effective for improving health outcomes.

Metabolic Syndrome

Metabolic syndrome (MS) includes having high blood pressure, high cholesterol, high blood sugar, and excess abdominal fat, which all increase the risk of cardiovascular disease. There is increasing evidence that the risk of developing features of MS is doubled in patients with severe psoriasis.

Diabetes

Diabetes is a disorder of high blood sugar levels due to problems with insulin. Chronically raised blood sugar will damage organ and blood vessels leading to further complications. It is suggested that psoriasis and diabetes have a genetic correlation, which puts patients with psoriasis at risk for diabetes. With lifestyle modifications, early detection and pharmacologic treatment (if necessary), blood sugar levels can be controlled to minimize diabetes complications.

Mental Health

Patients with psoriasis at risk for poor mental health. Up to 30% and 60% of patients with psoriasis may develop anxiety or depression, respectively, over the course of the disease. With the visibility and chronic features of psoriasis, psoriasis may have a negative impact on self-esteem and quality of life.

While suffering from psoriasis may not be in one’s control, learning how to cope with this difficult condition is. If needed, seeking professional help is not a sign of weakness, but rather is an integral part for the holistic treatment of psoriasis.

Conclusion

There is increasing evidence that having psoriasis puts patients at increased risk for both immune-mediated and non-immune mediated comorbidities. Immune-mediated conditions includes psoriatic arthritis, inflammatory bowel disease and uveitis, while non-immune mediated conditions include cardiovascular disease, metabolic syndrome, diabetes and mental health conditions. Learning more about these conditions and seeking professional health from healthcare providers is important for addressing any concerns.

This article was written by Felicia Tai, medical student, University of Toronto.

The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.