The Far-Reaching Impacts of Psoriasis: Understanding and Mitigating Risks

Announcer: 
This is DermConsult on ReachMD. On this episode, we’ll learn about the comorbidities that psoriasis patients may experience and recommendations for managing them from Dr. Jenny Murase. Dr. Murase is the Director of Medical Consultative Dermatology at the Palo Alto Foundation Medical Group and Associate Clinical Professor of Dermatology at the University of California, San Francisco. Here she is now.

Dr. Murase: 
Because psoriasis is a chronic inflammatory process, there are other organ systems that can be involved, so that can present as either an early heart attack, myocardial infarction, stroke, and peripheral vascular disease in the extremities. And so it’s important for patients to be aware that they’re at that increased risk of cardiovascular disease to have their blood pressure checked routinely as well. 

And in addition, if they develop gastrointestinal symptoms, inflammatory bowel disease is something else they’re at an increased risk for, and that includes things like Crohn’s disease or ulcerative colitis. 

In addition, if they’re having any eye pain or eye symptoms, there’s an increased risk of inflammation of the uvea of the eye—which is called uveitis—so it would be important to have an ophthalmologist check early to make sure that they’re not developing that symptom and need anti-inflammatory treatment to address it. 

Finally, patients with psoriasis are at increased risk of depression and anxiety as well, and so screening for symptoms of depression and anxiety and having them address that with their primary care doctor or psychiatrist can be very helpful to prevent the complications from undiagnosed psychologic disorders. 

And I think in terms of the patient’s ability to take charge of their own psoriasis and the potential effects that it would have on their body, different things they can do would be to decrease their risk of cardiovascular disease by a healthy diet and regular exercise. A diet such as the Mediterranean diet that is low in fat but also high in protein is a really good  diet for a patient with psoriasis to consider. And making sure that their weight stays within a normal range is also helpful, because fat itself has inflammatory properties, and so I have seen some patients over the years have their psoriasis improve just by the weight loss and decrease in fat alone. 

I think that, for as much as we all can control it, reducing stress and participating in wellness exercises, mindfulness is helpful. Stress is kind of like the volume knob on the stereo; it makes any inflammatory skin disease worse, and that’s particularly true for psoriasis. So finding ways to manage stress and minimize stressors in your life can be helpful in addressing the inflammation associated with the psoriasis. And that also applies to getting adequate sleep as much as possible. Restful sleep can calm the immune system and reduce inflammation as well. 

Announcer:
That was Dr. Jenny Murase talking about comorbidity considerations for patients with psoriasis. To access this and other episodes in our series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!