Dermatologists caution that severe cases of psoriasis can be associated with other serious medical conditions

Mar 5 2009

On the surface, the thick, red, scaly, itchy plaques of psoriasis - which have been shown to have a significant negative impact on a person's overall quality of life - may not appear to pose a serious health risk for patients. However, a growing body of research suggests that psoriasis patients are at an increased risk of developing serious medical conditions, including cardiovascular disease and diabetes, particularly when their psoriasis is severe.

Speaking today at the 67th Annual Meeting of the American Academy of Dermatology (Academy), dermatologist Joel M. Gelfand, MD, MSCE, FAAD, assistant professor of dermatology at the University of Pennsylvania School of Medicine in Philadelphia, spoke about this complex skin condition and its relationship to other serious medical conditions.

Dr. Gelfand explained that for the last two decades, research has shown that excessive inflammation is a critical feature of psoriasis. This discovery has led to innovative approaches to treating psoriasis, with therapies targeting selected areas of the immune system that are over-active in psoriasis patients. Excess inflammation also is present in other common conditions, such as hardening of the arteries, heart attacks, stroke, obesity and diabetes - which may explain why some psoriasis patients may be at an increased risk for developing these other serious conditions.

Studies show the link between patients with severe psoriasis and diabetes, heart attack and coronary artery disease occur independent of traditional risk factors for these other conditions - such as obesity, smoking or high blood pressure.

Furthermore, Dr. Gelfand's recent research suggests that patients with severe psoriasis may have shorter life expectancies than non-psoriasis patients. Specifically, he found that those with severe psoriasis may die three to five years earlier than patients who do not have the disease.

"Patient education is critical in the early detection and management of these related conditions, many of which can be controlled with proper medical care," said Dr. Gelfand. To minimize the risk of developing associated medical conditions, Dr. Gelfand recommended that psoriasis patients lead a healthy lifestyle, avoid smoking, maintain an ideal body weight and get routine screenings for cardiovascular risk factors - such as blood pressure and cholesterol checks.

"We need to educate psoriasis patients about the increased risk of cardiovascular disease so the prevention efforts can be instituted," explained Dr. Gelfand.

Experts in the dermatology and cardiology communities have issued consensus statements advocating that physicians educate patients with psoriasis - particularly if the disease is severe - about the potential association of psoriasis with other serious diseases, such as diabetes and cardiovascular disease.

Dr. Gelfand added that further research is needed to better determine how skin disease severity and activity affect the risk of developing these associated conditions and whether successful treatment of psoriasis alters the risks.

Psoriasis affects nearly 7 million Americans and can start at any age, although it most commonly starts in early adulthood (20s and 30s). Psoriasis has a genetic component, as approximately 40 percent of patients with psoriasis have a family history of the disease. While the exact cause of psoriasis is unknown, it is believed to occur due to an interaction of multiple genes, the immune system and the environment, according to Dr. Gelfand. The disease can be localized, affecting only the elbows or scalp, or can involve skin on the entire body.

To learn more about psoriasis, visit the PsoriasisNet section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

http://www.aad.org/