One of the critical features of psoriasis is chronic inflammation, a condition also seen in people withinsulin resistance, obesity , cardiovascular diseases and abnormal levels of cholesterol . Evidence is now emerging of a link between psoriasis and theseother serious diseases, prompting the American Academy ofDermatology to urge patients with psoriasis, particularly thoseseverely affected, to be more aware and monitor their health veryclosely for signs of these diseases. Dr Joel M. Gelfand, assistant professor of dermatology andepidemiology at the University of Pennsylvania Perelman School ofMedicine in Philadelphia, gave a presentation about it at theAmerican Academy of Dermatology's 70th Annual Meeting in San Diegolast week. In the United States there are about 7 million people withpsoriasis, including about 3 million who have never been diagnosed. |
The common, chronic skin condition is thought to be caused by acombination of genes, the immune system, and the environment. Itcan be localized, for instance only breaking out on the scalp orelbows, or it can be all over the body. Psoriasis forms as raised, red, scaly plaques that can itch, crackand bleed. The disease is painful and can cause disfigurement anddisability. In about 20% of cases, it is so severe that no amountof creams and ointments is enough to control it.
The disease can develop at any age, but usually it starts in the20s and 30s. Around 40% of people with psoriasis have a familyhistory of the disease. In around 10% of cases, patients develop arthritis with the skin condition: among those with extensive, severe skindisease, incidence of arthritis can be three or four times morecommon. In most instances, the skin condition appears before thearthritis. Gelfand told the meeting that studies using new techniques thatexamine the different types of cholesterol and what they do,suggest people with psoriasis have something in common with peoplewith diabetes: their LDL or "bad" cholesterol particles are smallerand denser.
Such particles are more likely to cause arteries tobecome stiff, increasing the risk of heart attack . And more recently, there is evidence that HDL or "good" cholesterolis impaired in psoriasis patients: their HDL can't get rid ofcholesterol from cells in the artery walls so easily. Gelfand also cited other research, involving more than 4,000 peoplewith psoriasis, that showed those whose psoriasis covered a greatersurface area of skin were more likely to have metabolic syndrome, agroup of medical disorders such as obesity, increasedtriglycerides, blood pressure, and levels of blood glucose, thattogether raise the risk of developing cardiovascular disease and diabetes . He said this study found a dose-response effect between psoriasisand metabolic syndrome: the more severe the skin disease, thestronger the link. Gelfand said some studies have tied severe psoriasis to increase inmajor cardiovascular events, such as heart attacks.
One study found that people with the severe form of the skindisease may die about five years younger than people without thedisease and that at least 50% of this effect is due tocardiovascular disease. Gelfand's advice to psoriasis patients seeking to reduce their riskof developing these serious diseases is: Don't smoke. Limit alcohol. Eat a healthy, balanced diet. Keep to a healthy weight.
Have an active lifestyle. Reduce stress . Have regular checks for blood pressure, blood sugar, cholesterol. In the meantime, Gelfand said more research needs to be done tofind out "how skin disease severity affects the risk of developinginsulin resistance, obesity, abnormal cholesterol levels andcardiovascular disease, and whether successful treatment ofpsoriasis alters these risks".
One such project, funded by the National Heart, Lung and BloodInstitute is already planned, said Gelfand. The multi-centerclinical trial will seek to discover if treatment of psoriasisaffects arterial inflammation, cholesterol function and metabolicdisease. Written by Catharine Paddock PhD Copyright: Medical News Today Not to be reproduced without permission of Medical News Today Additional References Citations.
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