Psoriasis is a chronic autoimmune condition primarily affecting the skin, causing patches of thickened, red, and scaly skin. However, its impact extends beyond visible symptoms, as it is recognized as a systemic disease. Other distinct medical conditions that can occur alongside psoriasis are known as comorbidities, and understanding these associations is important for overall health management.
The Systemic Inflammatory Link
The connection between psoriasis and other health conditions stems from chronic, systemic inflammation. In psoriasis, the immune system mistakenly targets healthy cells, leading to an overproduction of inflammatory proteins like cytokines. These same inflammatory pathways and molecules that cause skin plaques can circulate throughout the body, affecting other tissues and organs. This widespread inflammation can contribute to the development of related conditions in joints, blood vessels, and metabolic systems.
Associated Musculoskeletal and Autoimmune Conditions
Psoriasis frequently co-occurs with musculoskeletal and other autoimmune conditions due to shared inflammatory processes. Psoriatic arthritis (PsA) is a common comorbidity, affecting joints and sometimes the spine, causing pain, stiffness, and swelling. Unlike other forms of arthritis, PsA can also affect entheses, the sites where tendons or ligaments attach to bone, and can involve the nails, similar to skin psoriasis.
Beyond PsA, individuals with psoriasis have an increased likelihood of developing inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. These conditions involve chronic inflammation of the digestive tract and share common inflammatory pathways with psoriasis. Eye conditions, such as uveitis, an inflammation of the eye’s middle layer, are also more prevalent in people with psoriasis.
Cardiometabolic Health Risks
Psoriasis is also linked to a higher risk of serious cardiometabolic conditions. Individuals with psoriasis face an increased likelihood of major cardiovascular events, including heart attack and stroke. For instance, severe psoriasis has been associated with a greater absolute risk for major cardiac events compared to individuals without the condition. The systemic inflammation promotes atherosclerosis, which is the hardening and narrowing of arteries, contributing directly to heart disease.
Psoriasis is strongly associated with metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. This syndrome includes central obesity, high blood pressure (hypertension), elevated blood sugar levels, and abnormal cholesterol or triglyceride levels. Studies show that for every 10% increase in affected body surface area by psoriasis, the risk of type 2 diabetes increases by 20%.
Impact on Mental and Emotional Wellbeing
Living with psoriasis can significantly affect mental and emotional wellbeing, leading to higher rates of certain psychological conditions. Individuals with psoriasis often experience elevated levels of depression and anxiety compared to the general population. This connection is partly a reaction to managing a chronic, often visible skin condition that can impact self-esteem and social interactions. Emerging research also suggests that the systemic inflammation itself, which is characteristic of psoriasis, may contribute to the development of mood disorders by affecting brain pathways.
Proactive Health Management and Screening
Managing psoriasis effectively involves a proactive approach to overall health, including awareness and screening for associated conditions. Regular health screenings, such as blood pressure checks, blood tests for glucose and cholesterol levels, and discussions about mental health, are recommended.
Treating the underlying inflammation of psoriasis with systemic medications may also help lower the risk of developing some of these comorbidities. Adopting positive lifestyle choices, including a balanced diet, regular physical activity, and avoiding smoking, can further benefit both psoriasis symptoms and overall health. This comprehensive approach aims to manage the systemic nature of psoriasis and its broader health implications.