PsoriasisNet Spotlight Article
5 Medical Screenings People with Psoriasis Should Have

Research continues to show that having psoriasis increases your risk for getting other medical conditions. These conditions include heart disease, diabetes, and stroke.

The good news is that psoriasis is only one risk factor. You cannot change the fact that you have psoriasis. But you can change some risk factors. By having the following medical screenings, you can learn what risk factors you have. Best of all, you can do something about these risk factors.

1. Psoriatic arthritis screening
   Some people who have psoriasis get a type of arthritis called psoriatic arthritis. Be sure to tell your dermatologist if you have the following:

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

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

These may be early indications of psoriatic arthritis.

What’s involved: There is no test that can be used to diagnose psoriatic arthritis. Instead, your dermatologist will ask you questions and look at how you move. You may also need blood tests, an MRI, or x-rays.

What the results mean: If you have psoriatic arthritis, treatment will be recommended. Treatment helps to prevent further damage to your joints. Without treatment, psoriatic arthritis can cause deformed joints and disability.

2. Blood pressure check
   If you have high blood pressure, you have a greater risk for:

• Diabetes

• Heart disease

• Having a stroke

Since psoriasis also increases your risk for these medical conditions, it is important to have your blood pressure checked.

What’s involved: A nurse or other medical professional places a cuff on your arm, squeezes the cuff to make it tight, and slowly releases the pressure. Be sure to ask for the results.

What the results mean: When you ask what your blood pressure is, you will be given 2 numbers such as 120 over 80. The first number is the systolic number. The second number is the diastolic number. The following table from the Centers for Disease Control and Prevention (CDC) shows what these numbers mean:

Blood Pressure Levels
Normal	Systolic: less than 120 mmHg Diastolic: less than 80 mmHg
At risk (prehypertension)	Systolic: 120–139 mmHg Diastolic: 80–89 mmHg
High	Systolic: 140 mmHg or higher Diastolic: 90 mmHg or higher

Table taken from the Centers for Disease Control and Prevention (CDC) website, see High Blood Pressure.

If you have high blood pressure, you can lower it. Losing weight, exercising 3 times per week (30 minutes per session), and taking medicine are some ways to lower your blood pressure. By lowering your blood pressure, you can reduce your risk for developing diabetes, heart disease, and having a stroke.

3. Cholesterol test
   Knowing your cholesterol levels is important. When you have too much cholesterol in your blood, you have a higher risk for heart disease and stroke.
   
   Like blood pressure, the only way to know your cholesterol levels is to get them checked.
   
   What’s involved: A simple blood test.
   
   What the results mean:

   Desirable Cholesterol Levels
   Total cholesterol	Less than 200 mg/dL
   LDL ("bad" cholesterol)	Less than 100 mg/dL
   HDL ("good" cholesterol)	40 mg/dL or higher
   Triglycerides	Less than 150 mg/dL

   Table appears on the Centers for Disease Control and Prevention (CDC) website, see Cholesterol.
   
   If your cholesterol levels do not fall within the desirable range, there is good news. You can change your cholesterol levels. Things you can do to change your cholesterol include eating more fresh fruits and vegetables and losing weight.
    

4. Body mass index (BMI)
   Being overweight or obese increases your risk for developing many medical conditions. These include:

• Arthritis

• Diabetes

• Heart disease

Learning your BMI is a fairly accurate way to tell whether you have too much body fat.

What’s involved: You can find out your body mass index by using an online tool from the Centers for Disease Control and Prevention (CDC). All you need to do is type in your height and weight.

Adult BMI Indicator

What the result means: When you use the Adult BMI Indicator (link above), your result will be given as a number. This number tells you what range your weight falls within — underweight, normal, overweight, or obese.

If the number indicates that you are overweight or obese, you should discuss this with your dermatologist or family doctor. Losing weight can help reduce your risk for several diseases.

5. Glucose tolerance test
   Studies have found that people who have psoriasis have an increased risk of developing diabetes. A glucose tolerance test is one of the tests used to diagnose diabetes.
   
   What’s involved: The most widely used test is the oral glucose tolerance test. To have this test, you will need to fast. This means that you must not eat or drink anything after midnight on the day before the test. On the day of the test, you will first have your blood drawn. Then you will be asked to drink a liquid that contains glucose.
   
   You will then have blood draws every 30 to 60 minutes for up to 3 hours. The purpose of this test is to measure the amount of glucose in your blood at the time of the blood draw.
   
   What the results means: If you have too much glucose in your blood after each blood draw, you may have untreated diabetes.

Dermatologists also recommend that their patients with psoriasis make an appointment with their family doctor for a complete physical exam.

References:
Centers for Disease Control and Prevention. “Cholesterol.” Available at www.cdc.gov/cholesterol/what_you_can_do.htm. Last accessed January 7, 2011.

Centers for Disease Control and Prevention. “High Blood Pressure.” Available at www.cdc.gov/bloodpressure/what_you_can_do.htm. Last accessed January 7, 2011.

Centers for Disease Control and Prevention. “Adult BMI Calculator: English,” Available at www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. Last accessed January 7, 2011.

Gulliver, WP. “Importance of Screening for Comorbidities in Psoriasis Patients.” Medscape, posted 2008. Available at www.medscape.com/viewarticle/573087 . Last accessed January 7, 2011.