According to Jeffrey M. Weinberg, MD, an associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City, “there are multiple comorbidities” linked to psoriasis, including psoriatic arthritis (PsA), depression, inflammatory bowel disease, and diabetes. Systemic inflammation (inflammation throughout the body that isn’t limited to the skin) is one cause for many of these potential complications of psoriasis, according to Valori Treloar, MD, a dermatologist with Integrative Dermatology in Newton, Massachusetts. Another is insulin resistance, which also is associated with the condition. If you have psoriasis, it’s worth knowing about these seven associated health conditions, so you can keep an eye out for symptoms and, more important, take measures to lower your risk. For this reason, it can be hard to identify psoriatic arthritis. According to a study published in the Journal of the European Academy of Dermatology and Venereology, nearly 1 out of 10 psoriasis patients had undiagnosed psoriatic arthritis. A study published in the Journal of the American Academy of Dermatology put the number of undiagnosed patients even higher, at 15.5 percent, or roughly one out of six people. That said, it’s important to begin treating PsA as soon as it’s diagnosed to get control of it before it damages your joints or causes permanent disability. Being aware of the risk and keeping an eye out for symptoms and seeing your doctor as soon as you suspect you may be experiencing the early stages of psoriatic arthritis are key.
2. Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a condition of the female reproductive system in which small cysts (tiny sacs of fluid) form on the ovaries. PCOS is known to increase the risk of endometrial cancer. Studies point to a significant correlation between women with psoriatic disease and PCOS, which also is associated with other skin issues — namely, adult acne and male-pattern facial hair. PCOS also can be a factor in infertility. There are effective treatments for PCOS and the side effects it causes. These include medications such as birth control pills and metformin, an anti-inflammatory diet (which also may help ease psoriasis symptoms), and stress management.
3. Mental Health Disorders
Many people with psoriasis, especially those who are young, develop a negative body image and low self-esteem as a result of the visible symptoms of psoriasis, putting their mental health at risk. According to the National Psoriasis Foundation, “people with psoriatic disease are 39 percent more likely to be diagnosed with depression and 31 percent more likely to be diagnosed with anxiety” than those who don’t have psoriasis. What’s more, there’s evidence that while psoriasis can lead to depression, there’s a reverse dynamic in play as well: Depression can make psoriasis worse. According to a study published in August 2020 in the journal Cureus, “psoriasis and depression amplify each other.” The researchers explain both conditions share certain underlying causes, including inflammation, family history, and low levels of vitamin D3.
4. Metabolic Syndrome
Metabolic syndrome is a condition characterized by high blood pressure, increased waist circumference, elevated blood sugar levels due to insulin resistance, and elevated blood fats. A study published in the journal Anais Brasileiros de Dermatologia found people with psoriasis were nearly six times more likely to have metabolic syndrome than their peers. Whether psoriasis predisposes people to metabolic syndrome or vice versa isn’t clear, but experts stress that it’s especially important people with psoriasis do all they can to lower their risk of metabolic syndrome, including maintaining a healthy weight, eating a varied diet low in saturated fats, and getting plenty of exercise.
5. Heart Disease
According to a study published in April 2021 in the Journal of the American College of Cardiology, people with psoriasis are at an increased risk of cardiovascular disease. Additional traditional risk factors can further increase risk, and so your psoriasis diagnosis and treatment should be considered in your cardiovascular disease prevention strategy. “Chronic inflammation has long been associated with an increased risk of heart attack and stroke,” says Kevin R. Campbell, MD, a cardiologist at Health First in Melbourne, Florida. That’s because inflammation can damage arteries. If you have psoriasis, it’s important to monitor your heart health and take steps to lower your risk of heart disease. “I make the point of saying the first-line treatment for psoriasis is diet and lifestyle,” says Dr. Treloar.
6. Chronic Obstructive Pulmonary Disease
The inflammation associated with psoriasis can affect the lungs and raise the risk for chronic obstructive pulmonary disease (COPD) — a group of lung conditions that block airflow and make it hard to breathe. Research bears this out. For example, a study published in the journal PLoS One reported people with psoriasis have a two-fold increased risk of developing COPD, especially those whose disease is severe. For this reason, people with psoriasis shouldn’t smoke and should avoid lung irritants like air pollution, chemical fumes, and dust that contribute to COPD risk. Doctors should test at-risk patients early for reduced lung function.
7. Cancer
“Psoriasis alters your immune system in such a way that overall inflammation is increased, which can slightly increase your risk of developing cancers,” says Stephanie K. Fabbro, MD, dermatologist at Buckeye Dermatology and core faculty member at Riverside Methodist Hospital Dermatology Residency Program at OhioHealth. In particular, psoriasis is associated with non-melanoma skin cancer, lymphoma, and lung cancer, according to a study published in May 2020 in the journal Expert Review of Clinical Immunology. The researchers cited “chronic low-grade inflammation” as one potential reason for the link, along with certain behaviors such as smoking and alcohol use that tend to be more common in people with psoriasis. They also cited the possibility that some psoriasis medications might be involved. The bottom line: Although there appears to be a connection between psoriasis and a number of other chronic conditions, these complications are not inevitable. By managing your psoriasis, maintaining a healthy lifestyle, and working closely with your healthcare providers, you can take your future health into your own hands and lower your risk of adding the insult of a second chronic disease to the injury of psoriasis.
