The term "comorbid" describes the presence of one or more diseases in addition to the underlying primary disorder. Patients with psoriasis can be at increased risk for developing a number of other important medical conditions. These diseases or comorbid conditions are often chronic (long-lasting), and can have a significant impact on patients' quality of life, productivity at work, and general health. Comorbidities in patients with psoriasis can include arthritis (psoriatic arthritis), depression, inflammatory bowel disease, lymphoma, and the so-called metabolic syndrome (the coexistence of heart disease, high blood pressure, and obesity).
Heart Disease
Several research studies have reported the association of ischemic (ischemia describes decreased blood supply to an organ, tissue, or part caused by constriction or obstruction of the blood vessels) heart disease or coronary artery disease and psoriasis. Several large studies, which compared a group of patients with psoriasis and a group of patients without psoriasis, found that in the group with psoriasis there were increased rates of obesity, high blood pressure (hypertension), and heart disease. In medicine, the term often used to describe the grouping of high blood pressure, heart disease, and obesity is "the metabolic syndrome." These are recognized risk factors for heart disease.
Depression or Depression Symptoms
Psoriasis can have a significant negative impact on patients' quality of life and lead to depressive symptoms. In several large clinical studies of patients who undergo treatment with a biologic therapy, almost a third were found to have symptoms of depression at baseline. Not surprisingly, other findings showed that the degree of depression is related to the severity of psoriasis, and that patients with severe disease were more likely to have thoughts of suicide.
Psoriatic Arthritis
Psoriatic arthritis is one of the most common associations with psoriasis, occurring in approximately a third of patients with psoriasis.
Cancer
Several studies have shown that psoriasis and treatments for psoriasis are associated with an increased risk of cancer. For example, skin cancer, particularly squamous cell cancer, has been associated with psoriasis patients, particularly those who have received phototherapy. Lymphoma (malignant tumors) has also been recognized as a health concern that is associated with psoriasis. An increase in the risk of lymphomas in psoriasis patients, particularly those with more severe psoriasis, has been documented. It is not clear yet what part, if any, of this risk is due to medications used to treat psoriasis compared to the risk, if any, of having the skin disease psoriasis.
What Can You Do about the Possibility of Comorbidities?
Be encouraged by the fact that many of the risk factors, particularly the cardiac risk factors, can be modified. Weight loss, exercise, reduction of stress, and cessation of smoking are key components to help reduce the risk of cardiac disease. Talk to your physician to discuss particular measures. Recent and ongoing research suggests that some of the associated health concerns, such as depression and risk of cancer, may be reduced by the effective treatment of psoriasis.
All these findings go a long way to emphasize the importance of treating a chronic inflammatory disease, such as psoriasis, as these diseases may have an effect on your general health. In this sense, psoriasis is truly more than just "skin deep." To find out more, you can check out Comorbid Psoriasis.