Psoriasis is an interesting disorder. It affects about 2% of the US population. As I often explain to patients, it is something that some people are genetically inclined to have, just like their hair color and eye color. It is not some we can permanently cure, and for most it is a lifelong disorder that comes and goes. BUT…What we knew, or what we thought we knew about psoriasis has changed dramatically in just the past 15-20 years. Each day it seems we learn more. Some of the new findings are particularly startling.
Many studies have shown that people who have psoriasis are statistically at a higher risk of having a number of other disorders and risks. We label these statistical findings as comorbidities. The official definition of a comorbidity is “the simultaneous presence of two chronic diseases or conditions in a patient”. Why does this matter?
At the American Academy of Dermatology meeting last spring, I attended a number of scientific lectures which discussed these comorbidities. At that meeting it was emphasized that it would increasingly be important for us as dermatologist to educate patients regarding these comorbidities and risk factors. This topic is evolving and advancing daily, but I wanted to try to summarize this topic for my patients. So, here we go….
Comorbidities with psoriasis…
Obesity – 2x increase risk
Type 2 diabetes -2x
Coronary artery disease –2 x
Arthritis– About 30% of patients who have psoriasis have psoriatic arthritis. This is a destructive type of arthritis.
High blood pressure – up to 2x
Inflammatory Bowel Disease –Crohn’s and Ulcerative Çolitis 3.8 to 7.5x
Fatty Liver and other Liver Disease – up to 2x
Depression – up to 60% of patients with psoriasis
Lymphoma – up to 2x
Metabolic syndrome (includes high blood pressure, elevated blood glucose, elevated lipids, and obesity) – 2x
Increase risk of non-melanoma skin cancer – 4x
A significant amount of current research is looking for substantial evidence for systemic treatment of psoriasis to reduce these comorbidities and increase life span.
Recommendations for psoriasis patients to reduce risk of illness and death from comorbid disease…
-Yearly physical by PCP
-Yearly Full skin examination
-Yearly set of lab work including Fasting blood glucose, Hemoglobin A1C, Cholesterol, triglycerides, Liver (AST, ALT, GGT) and kidney function tests (BUN and Creatinine)
-Keep up to date on age appropriate malignancy scans.
-Reducing weight by as little as 10% significantly improves cardiovascular risk
-Reducing and limiting alcohol intake
-Cardiovascular exercise at least 3-4 times per week.
-Daily Vitamin E 400IU, Fish Oil
-Coffee, black , in moderation
If you have a friend or relative with psoriasis, please share this information with them!
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