PsoriasisNet Spotlight Article
Psoriasis Increases Risk for Some Medical Conditions

If you have psoriasis, you may have an increased risk for getting some other medical conditions. The following tells you what researchers have discovered about 10 medical conditions and how real the risk is for each.

You’ll also find signs and symptoms that you should know. Caught early, these conditions often can be cured or controlled. For example, if you feel stiffness in your joints when you wake up, you could have psoriatic arthritis. Catching this early and treating it can prevent permanent damage to your joints.

1. Psoriatic arthritis
   Risk: Yes, people who have psoriasis can get this type of arthritis. Psoriatic arthritis is a common related medical condition. It can appear at any time, but most people get psoriatic arthritis about 7 to 10 years after getting psoriasis.
   
   Signs and symptoms to watch for: Make an appointment to see your dermatologist right away if you have any of these early warnings of psoriatic arthritis:

• Changes to your fingernails or toenails, such as pits or crumbling nails

• Achy, stiff, or painful joints, especially when waking up

2. High blood pressure
   Risk: Yes, studies show people who have psoriasis often have high blood pressure.
   
   Signs and symptoms to watch for: Often none. Most people find out they have high blood pressure when they get it checked.
   
   If you have high blood pressure, you can lower it. Eating healthy foods, exercising, and taking medicine are a few ways to lower blood pressure.
    

3. Cancer
   Risk: More research is needed. Some studies suggest that psoriasis increases your risk of getting some types of cancer. Others studies do not show this. The following summarizes what the research shows.

• Lymphoma (cancer that begins in the lymphatic system, which is part of our immune system): We still do not know whether people who have psoriasis have a higher risk. Some studies show a higher risk. Other studies do not.

• Melanoma and other skin cancers: If you are white and had more than 250 PUVA treatments for your psoriasis, research shows that you have a greater risk of getting a type of skin cancer called squamous cell carcinoma. Some studies suggest that having 250+ PUVA treatments also increases the risk of getting melanoma in whites. But not everyone agrees.

Signs and symptoms to watch for: Lymphoma often causes swollen lymph nodes in the neck, armpits, or groin. You may have unexplained weight loss, fever, or soaking night sweats.

Skin cancer begins on the skin, so it can often be caught early and cured. If you notice anything on your skin that changes, grows, or bleeds, tell your dermatologist.

4. Cholesterol levels (unhealthy)
   Risk: Yes, your risk of having unhealthy cholesterol levels is greater.
   
   Signs and symptoms to watch for: Often none. Most people learn that they have unhealthy cholesterol levels when they have a cholesterol test. This is a simple blood test.
   
   If the test shows that you have unhealthy cholesterol levels, you can change this. Losing weight, eating a healthy diet, and taking medicine are options for getting your cholesterol into a healthy range.
    

5. Crohn’s disease
   Risk: Yes, studies show that if you have psoriasis, you have a greater risk of getting Crohn’s disease.
   
   Signs and symptoms to watch for: Crohn’s disease affects the digestive system. Common signs and symptoms of Crohn’s are:

• Persistent diarrhea

• Cramps and pain in your abdomen

• Fever

• Tiredness that won’t go away

• Bleeding from the rectum

Treatment for Crohn’s disease can help alleviate the signs and symptoms. And, be sure to tell your dermatologist if you develop any of the signs and symptoms of Crohn’s. This information may affect your treatment for psoriasis.

6. Depression
   Risk: Yes, many people living with psoriasis often suffer from depression.
   
   Signs and symptoms to watch for: The National Institute of Mental Health (NIMH) lists the following as symptoms of depression:

• Feeling sad, anxious, or "empty" for more than a couple of days

• Feelings of hopelessness and/or pessimism

• Feelings of guilt, worthlessness, and/or helplessness

• Irritability, restlessness

• Loss of interest in activities or hobbies once pleasurable, including sex

• Fatigue and decreased energy

• Difficulty concentrating, remembering details and making decisions

• Insomnia, early-morning wakefulness, or excessive sleeping

• Overeating or appetite loss

• Thoughts of suicide, suicide attempts

• Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

You may feel that nothing can help ease these signs and symptoms. This is actually a symptom of depression. Most people, even those with severe depression, can get better with treatment. Treatment may include taking medicine or talking with a therapist.

Research also shows that many people find that their depression eases when they treat their psoriasis.

7. Diabetes
   Risk: Yes, a large study found that people who have psoriasis have a greater risk of developing diabetes. This risk increases with time and is greater in people who have psoriasis that covers a large portion of the body or when psoriasis is disabling.
   
   Signs and symptoms to watch for:

• Excessive thirst

• Feeling hungry even after eating

• Unexplained weight loss

• Frequent urination

• Blurry vision

• Feeling tired all the time

• Skin and urinary tract infections that clear and then return

If you have any of the signs and symptoms of diabetes, make an appointment to see your dermatologist or family doctor as soon as possible. Treating diabetes can prevent serious complications such as problems with your vision and kidney disease.

8. Heart disease
   Risk: Yes, research shows that people who have psoriasis have a greater risk of getting heart disease.
   
   Signs and symptoms to watch for: In the early stages, heart disease often does not cause any signs or symptoms.
   
   Medical tests can find early heart disease. For this reason, many dermatologists now recommend the following medical tests:

• Blood pressure check

• Cholesterol test

• Electrocardiogram

9. Multiple sclerosis (MS)
   Risk: Studies suggest that having psoriasis may increase the risk of getting MS. There seems to be a genetic relationship between psoriasis and MS.
   
   Signs and symptoms to watch for: The most common early signs and symptoms of MS are:

• Having sensations such as tingling, numbness, and “pins and needles”

• Problems with coordination or balance

• Blurry or double vision

• Weakness

• Trouble concentrating or forgetfulness

10. Sleep problems: Yes. In one study, almost half (49.5%) of the patients said their psoriasis affected their ability to sleep at least once a month. They said the itch and pain can keep them awake.
    
    Talk with your dermatologist if you have problems sleeping. Many people living with psoriasis believe that a good night’s sleep helps to control their psoriasis. In one survey, 57% of patients said that a good night’s sleep could get rid of their itching.

If you have any of the signs and symptoms listed above, be sure to tell your dermatologist.

Learn more
Psoriasis Can Lead to Depression
What is Psoriatic Arthritis?

References:
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Gowda S, Goldblum OM, McCall WV et al. Factors affecting sleep quality in patients with psoriasis. J Am Acad Dermatol; 63: 114-23.

Kimball AB, Gladman D, Gelfand JM et al. National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol 2008; 58: 1031-42.

Kurd SK, Troxel AB, Crits-Christoph P et al. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol; 146: 891-5.

Mease PJ, Menter MA. Quality-of-life issues in psoriasis and psoriatic arthritis: outcome measures and therapies from a dermatological perspective. J Am Acad Dermatol 2006; 54: 685-704.

Menter A, Gottlieb A, Feldman SR et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 2008; 58: 826-50.

Najarian DJ, Gottlieb AB. Connections between psoriasis and Crohn's disease. J Am Acad Dermatol 2003; 48: 805-21; quiz 22-4.

Neimann AL, Shin DB, Wang X et al. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol 2006; 55: 829-35.

Prodanovich S, Kirsner RS, Kravetz JD et al. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol 2009; 145: 700-3.

Soltani-Arabshahi R, Wong B, Feng BJ et al. Obesity in early adulthood as a risk factor for psoriatic arthritis. Arch Dermatol; 146: 721-6.

U.S. National Library of Medicine National Institutes of Health. “Multiple Sclerosis.” Available at www.nlm.nih.gov/medlineplus/multiplesclerosis.html. Last accessed January 7, 2011.

U.S. Library of Medicine National Institute of Mental Health, “What are the signs and symptoms of depression?” Page last updated September 23, 2009. Available at www.nimh.nih.gov/health/publications/depression/complete-index.shtml#pub3. Last accessed January 7, 2011.