I'll be honest with you. If you have psoriasis, what you doctor doesn't know might kill you. Strong words? Yes, but lately so much data is accumulating about psoriasis and general health that this topic is taking on great importance -- much more so than when I trained as a dermatologist. Most doctors in practice today probably still look at psoriasis as simply a skin rash. We now know that psoriasis can be an indicator of many more serious underlying conditions. Both you and your doctor need to be aware of the risks associated with having psoriasis.
Case in point: Research on the United Kingdom's colossal General Practice Research Database (GPRD) -- a bank of information on 9 million patients, more than 100,000 of whom have a diagnosis of psoriasis. Researchers looked for trends, and found some eye-opening information we had better pay close attention to.
Psoriasis and the Risk of LymphomaPsoriasis, like rheumatoid arthritis (RA), is an autoimmune condition that has been associated with an increased risk of lymphoma. There are several types of lymphoma, at least two of which are increased in patients with psoriasis by as much as 10-fold over patients without the skin condition.
Lymphoma is a cancer of white blood cells which typically leads to swollen lymph nodes. Many lymph nodes are superficial and can be palpated (felt) by your physician during a routine exam. If enlarged lymph nodes are felt, they can be further investigated.
Psoriasis and the Risk of Heart AttackModerate to severe psoriasis can pose as much as a 3-fold increase for the risk of a heart attack. Chronic inflammation, as is seen in psoriasis, is now believed to be a major player in the development of heart disease. Blood tests, such as C-reactive protein (CRP), are often done to screen for risk of heart attack and should be a routine part of your lab work if you have moderate to severe psoriasis. If you have other risk factors for heart disease, such as diabetes, high blood pressure, or obesity, make sure you and your doctor address these aggressively as well.
Severe Psoriasis and Increased Risk of DeathIn the U.K. study, the risk of overall mortality (death) was increased in people with severe psoriasis by roughly 50%, with these patients experiencing about a 4-year shorter life span. Though worth noting, these figures are less troublesome than those from other research in Canada. In this study, life expectancy was decreased by 10 years over the Canadian average; for those who developed psoriasis before age 25, life expectancy was decreased by 25 to 30 years. A truly startling statistic.
What Else Can Psoriasis Patients Do?In addition to the above, the Canadian study found that diabetes and genitourinary (reproductive and urinary) diseases were more common in psoriasis patients. The lead researcher suggested that psoriasis patients get regular blood pressure, blood sugar, and lipid tests, as well as electrocardiograms.
Let Your Physician KnowThe information presented here is relatively new. Do yourself a favor -- let your physician know that you are concerned. While the screenings mentioned here may be a part of your routine physical, it is certainly a good idea to discuss the association of psoriasis and these other conditions with your doctor.
Source: Epidemiology and Psoriasis - Eye-Opening Results that Impact Patient Care. Dermatology Focus Winter 2007/2008; vol. 26 No. 4:1-10