Psoriasis involves a complex interplay within the body. While it does not typically lead to neuropathy as a direct cause-and-effect, an established association and increased risk exist due to shared underlying mechanisms or co-occurring conditions. This relationship is often indirect, stemming from the systemic inflammatory nature of psoriasis or from common health issues that frequently affect individuals with the condition.
Understanding Psoriasis and Neuropathy
Psoriasis is a chronic autoimmune condition primarily affecting the skin, characterized by a rapid turnover of skin cells. This accelerated growth results in thick, scaly, inflamed patches. Beyond its visible manifestations, psoriasis is considered a systemic inflammatory disease, as it involves inflammation throughout the body.
Neuropathy refers to damage to nerves outside the brain and spinal cord. These nerves transmit signals between the central nervous system and the body’s muscles, organs, and sensory receptors. When damaged, it can lead to symptoms like numbness, tingling, pain, or muscle weakness, most commonly in the hands and feet.
Exploring the Potential Connection
The connection between psoriasis and neuropathy is largely attributed to chronic inflammation. The immune system in psoriasis produces inflammatory cytokines. These inflammatory mediators can affect the nervous system, potentially contributing to nerve dysfunction or damage over time. This ongoing systemic inflammation may create an environment conducive to nerve issues.
Individuals with psoriasis often experience other health conditions that are known causes of neuropathy. Psoriatic arthritis involves inflammation in the joints. This inflammation can lead to swelling and tissue changes around joints, which may compress or entrap nearby nerves, resulting in nerve pain and dysfunction.
Metabolic conditions frequently occur alongside psoriasis, notably diabetes and metabolic syndrome. Diabetes is a leading cause of peripheral neuropathy, where high blood sugar levels can damage nerves throughout the body, most often in the legs and feet. The increased prevalence of diabetes in individuals with psoriasis can significantly raise their risk of developing diabetic neuropathy.
Certain medications used to manage moderate to severe psoriasis can also have neurological side effects. Some immunosuppressants and biologic therapies may cause tingling, numbness, or headaches. Rare cases of new or exacerbated neurological complications have been associated with biologics. While these occurrences are uncommon, they highlight a potential indirect link between psoriasis treatment and neurological symptoms.
Emerging research further explores the relationship, with studies suggesting a higher risk of polyneuropathy in individuals with psoriasis or psoriatic arthritis compared to those without these conditions. This increased risk appears to be largely linked to the higher prevalence of co-occurring conditions that contribute to neuropathy, rather than a direct effect of psoriasis on nerve damage. Small fiber neuropathy, which affects nerves responsible for pain and temperature sensation, is another area being investigated for its potential connection to psoriasis.
Recognizing Symptoms and Other Causes
Neuropathy symptoms commonly include numbness, tingling, or a “pins and needles” sensation, often starting in the feet and hands and potentially spreading upwards. People might also experience sharp, burning, or shooting pain, heightened sensitivity to touch, muscle weakness, or a loss of balance.
It is important to differentiate between true nerve damage and other psoriasis-related discomforts. For instance, the severe joint pain experienced in psoriatic arthritis might be mistaken for nerve pain, but it originates from joint inflammation rather than nerve damage. Skin pain from psoriasis lesions, characterized by burning or itching, is also distinct from neuropathic pain.
Neuropathy is a widespread condition with numerous potential origins beyond psoriasis. Diabetes is the most frequent cause, but other factors include vitamin deficiencies, particularly B vitamins, and chronic alcohol consumption. Infections, such as shingles or HIV, can also damage nerves. Autoimmune diseases like lupus or rheumatoid arthritis, physical injuries, certain medications (including some chemotherapy drugs), kidney or liver disorders, and genetic conditions are additional common causes.
Diagnosis and Treatment
If you experience persistent or worsening neurological symptoms, especially if you have psoriasis, consulting a healthcare professional is important. Early evaluation helps determine the underlying cause and guide appropriate management, as untreated neuropathy can lead to more severe complications.
Diagnosing neuropathy typically involves a comprehensive approach. A doctor will conduct a physical and neurological examination, assessing reflexes, muscle strength, and sensory perception. Blood tests are often performed to check for common underlying conditions such as diabetes, vitamin deficiencies, or markers of autoimmune activity. Nerve conduction studies (NCS), electromyography (EMG), or imaging tests like MRI may also be used to measure nerve signals or check for compression.
Treatment for neuropathy focuses on managing the identified underlying cause and alleviating symptoms. If a co-occurring condition like diabetes is contributing, controlling blood sugar levels is a primary goal. Effective management of psoriasis can also help reduce systemic inflammation that might impact nerves. Symptomatic relief may involve various medications, physical therapy to improve muscle strength and control, or other pain management strategies.