Because psoriasis is a skin condition, the symptoms — particularly, discoloration and raised patches of skin — are hard to miss. But the effects of psoriasis can extend beyond the skin to areas of the body that are not visible, such as other organs and tissues. As a result, this skin condition has been linked to a number of chronic health conditions.
According to Jeffrey M. Weinberg, MD, a clinical professor of dermatology at Icahn School of Medicine at Mount Sinai in New York City, multiple comorbidities (diseases or conditions that occur in a person at the same time) are linked to psoriasis.
Systemic inflammation, which is throughout the body, not limited to the skin, is one cause of 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 is also associated with psoriasis.
If you have psoriasis, it’s worth knowing about some of the most common associated health conditions, so you can keep an eye out for symptoms and, more important, take measures to lower your risk.
1. Psoriatic Arthritis
Approximately one in three people with psoriasis eventually develop psoriatic arthritis (PsA), which can cause stiffness and pain in joints, swelling of the soft tissue surrounding joints, and a decrease in range of motion, according to the National Psoriasis Foundation (NPF).
Because the symptoms of PsA are similar to other types of arthritis, it can be hard to diagnose. According to a study, it’s common for people who have psoriasis to experience a two-year delay in getting a PsA diagnosis. And a review found that as many as 15 percent of people with psoriasis are affected by PsA but remain undiagnosed.
Any delay in diagnosis can be particularly problematic for people with PsA, because early detection and treatment under the care of a rheumatologist are crucial to managing the disease and reducing your risk of irreversible damage to your joints, according to the review authors.
Being aware of the risk, keeping an eye out for symptoms, and seeing your doctor as soon as you suspect you may be experiencing the early stages of PsA are key to managing the joint disease.
2. Mental Health Disorders
Many people with psoriasis develop a negative body image and low self-esteem as a result of the visible symptoms of psoriasis. This can contribute to an increased risk of anxiety and depression, according to the NPF.
People with psoriasis are 1.5 times more likely to show signs of depression, and they have a 20 to 50 percent greater risk of anxiety, compared with people who don’t have the skin condition, according to a review.
And, the NPF notes, children and teens who have psoriasis or psoriatic disease are at a higher risk of developing these mental health complications.
While psoriasis can lead to depression, there’s also evidence that a reverse dynamic is in play as well: Depression can make psoriasis worse. According to research, psoriasis and depression amplify each other, and both conditions share certain underlying causes, including inflammation, a family history of it, and low levels of vitamin D3.
3. 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. Combined, these factors up your risk of coronary heart disease, stroke, diabetes, and other serious health problems, according to the National Heart, Lung, and Blood Institute.
According to a review, an estimated 20 to 50 percent of people with psoriasis are affected by metabolic syndrome, and the risk of having this health issue increases with the severity of the psoriasis.
Whether psoriasis predisposes people to metabolic syndrome or vice versa isn’t clear. But experts stress that it’s especially important for people with psoriasis to 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.
4. Heart Disease
According to one study, people with psoriasis are at an increased risk of cardiovascular disease. That risk can increase further if you have additional common risk factors, such as high blood pressure, high low-density lipoprotein (LDL, or “bad”) cholesterol, and obesity. So if you have psoriasis, you should consider a cardiovascular disease prevention strategy part of your psoriasis treatment and management.
“Chronic inflammation has long been associated with an increased risk of heart attack and stroke,” says Kevin 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.
5. Sleep Disorders
A review found that sleep disorders, which can have a significant impact on physical and psychological health, are common in people with psoriasis. The researchers noted that sleep apnea is prevalent among people with psoriasis, affecting an estimated 36 to 82 percent. They also found that people who have psoriasis have an increased risk of insomnia and restless legs syndrome.
And the relationship goes both ways, according to the review: Sleep disorders increase your risk for developing diabetes, cardiovascular disease, high blood pressure, depression, and anxiety, which are all comorbidities of psoriasis.
The researchers stress the importance of assessing and addressing sleep problems if you have psoriasis, because early detection and treatment can greatly affect quality of life. For instance, the review notes, research has shown that treatment of sleep apnea with continuous positive airway pressure (CPAP) leads to an improvement in psoriasis lesions and a reduction in inflammation.
6. Chronic Obstructive Pulmonary Disease
The inflammation associated with psoriasis can affect the lungs and raise the risk for lung diseases such as chronic obstructive pulmonary disease (COPD), which is a collective term for a group of lung conditions that block airflow and make it hard to breathe.
According to a review, a number of studies have shown that COPD, asthma, and other lung conditions are prevalent in people with psoriasis. And even people with mild cases of psoriasis are at an increased risk of developing COPD.
The researchers note that lung diseases can have a negative effect on quality of life for people with psoriasis, and that COPD — like other comorbidities of psoriasis, such as sleep apnea and high blood pressure — can have a big impact on your overall health and lifespan. Because of this, it’s important for anyone with psoriasis to be screened for lung issues and get treatment if necessary.
People with psoriasis should also avoid lung irritants, such as smoking and exposure to air pollution, chemical fumes, and dust, which all contribute to COPD risk.
And doctors should test at-risk patients early for reduced lung function.
7. Uveitis
Uveitis is inflammation of the eye that causes pain, redness, and blurry vision. If untreated, it can lead to vision loss. It’s estimated to occur in 7 to 20 percent of people who have psoriasis, according to an article in the journal Psoriasis: Targets and Therapy. The incidence tends to be higher in people who have both psoriasis and PsA, but there’s growing evidence that psoriasis alone, without PsA, is associated with an increased risk of uveitis.
The article authors says that the link between psoriasis and uveitis isn’t yet fully understood and more research needs to be done. But they also note that regular eye exams are crucial for people who have psoriasis, even when there aren’t any symptoms of eye or vision problems. Early diagnosis and treatment can help decrease systemic inflammation and may help improve both psoriasis and uveitis.
8. 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, a dermatologist at OhioHealth Riverside Methodist Hospital in Columbus.
In particular, psoriasis is associated with nonmelanoma skin cancer, lymphoma, and lung cancer, according to a review. 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 said there’s a 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.
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