Patients with mild, moderate and severe psoriasis had increasingly higher odds of having at least one co-morbidity when compared with patients without psoriasis, according to a study.
In a study published Aug. 7 on the website of JAMA Dermatology, researchers from the Perelman School of Medicine at the University of Pennsylvania concluded that the severity of disease, as measured by the percentage of body surface area affected by psoriasis, was strongly linked to an increased presence of other diseases affecting the lungs, heart, kidneys, liver and pancreas.
The research was part of the Incident Health Outcomes and Psoriasis Events (iHOPE) Study. The investigators surveyed general practitioners caring for 9,035 psoriasis patients; 52% had mild disease, 36% had moderate disease and 12% had severe disease affecting more than 10% of their body surface area.
Significant associations were found between psoriasis and a range of diseases, including chronic pulmonary disease, diabetes, mild liver disease, myocardial infarction and peripheral vascular disease, peptic ulcer disease, renal disease and other rheumatologic diseases.
“As we identify additional diseases linked to psoriasis, patients and physicians need to be aware of the increased odds of serious co-morbid illnesses, which is especially important in severe cases,” Joel M. Gelfand, MD, MSCE, the studys senior author and an associate professor of dermatology and epidemiology, said in a news release.
“The complications from diabetes and links to COPD, kidney disease and peptic ulcers we identified suggest new areas for research, while for the first time demonstrating how increasing body surface area affected by psoriasis is directly associated with increasing risk of atherosclerotic disease.”
Although psoriasis is thought of as a disease limited to skin and joints, earlier work from the interdisciplinary research team has demonstrated systemic effects, particularly in relation to diabetes, cardiovascular disease and mortality. A higher risk of diabetes previously was identified in psoriasis patients, and this study revealed that additional diabetes-associated systemic complications, such as retinopathy and neuropathy, were correlated with the severity of psoriasis as well. The diseases share a common pathway, TH-1 cytokines, which are known to promote inflammation and insulin resistance. By identifying these co-occuring diseases, the researchers hope patients will receive comprehensive care with proper health screening, evaluation and management.
The investigators are conducting the Vascular Inflammation in Psoriasis Trial, designed to determine whether different treatment approaches to psoriasis are likely to lower the risk of cardiovascular disease.
Read the study: http://archderm.jamanetwork.com/article.aspx?articleid=1724035.