Psoriasis Advance
Got psoriasis?
You may be at risk for other serious diseases
By Heather Johnson Durocher
From Summer 2009 Psoriasis Advance
Knowing that depression is often linked with psoriasis, dermatologist Raymond Dean has always stressed to his patients the importance of taking care of their overall health. Nowadays, the Traverse City, Mich., physician is even more adamant about patients' well-being, having learned of other health risks found to be more prevalent in those who have the chronic disease.
Looking beyond patients' skin became a greater focus after he reviewed study findings published last year in the Journal of the American Academy of Dermatology (JAAD). The report, published online in the JAAD, found that psoriasis is linked with a number of serious medical conditions, including cardiovascular disease and cancer.
"Our review found that people with more severe cases of psoriasis appear to have an increased incidence of psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer, depression, obesity and even other immune-related conditions such as Crohn's disease," said one of the study's researchers, Dr. Alexa Kimball, vice chair of dermatology, Massachusetts General Hospital, and associate professor at Harvard Medical School.
The report struck a chord with Dean, whose patients often are struggling with other health problems, such as obesity, depression and high cholesterol.
"I think the article is making dermatologists think about the patient's health as a whole and not just concentrate on their skin. There may be many psoriasis patients who see a dermatologist but don't have a primary care doctor and get yearly physicals," Dean said. "I am starting to mention this to my patients, especially those with high-risk factors. I'm starting to say to them, 'A risk with your psoriasis being so bad are these (diseases), and if you haven't gotten your physical in a while, you should think about doing that.'" Dean acknowledged that it's difficult to pinpoint how closely linked psoriasis is to other conditions. While these recent findings suggest an association with other health risks, "there were no solid conclusions as to whether chronic psoriasis actually causes one to have cardiovascular disease," he said.
"It's a chicken-and-egg thing—which comes first?" said Dean, who believes family history needs to be considered as well. "Does chronic inflammation of the skin contribute to chronic inflammation internally, leading to CVD (cardiovascular disease)? That is still not concrete." In light of these newer findings, experts recommend that you talk openly with your dermatologist—whether your psoriasis is mild or severe.
"I think if psoriatic patients and dermatologists start having these discussions, early interventions may be taken to address the patients' cardiovascular risk factors," Dean said.
Added Kimball: "It does appear that the risk of most of these go up with the severity of psoriasis, but you do see some mild elevation in even less severe cases."
Heather Johnson Durocher is a freelance writer who lives in Traverse City, Mich.
Her Web site is www.heatherdurocher.com.
Read a Journal of the American Academy of Dermatology article (PDF) about the study, which also addresses what doctors should do with this information.