More Clinical Pearls on Psoriasis

Joel Gelfand, MD

What about common comorbidities associated with psoriasis? Dr Gelfand highlights important clinical pearls…

• The risk of comorbidities generally increases with the severity of psoriasis, patients with more severe disease have a 5 year reduction in life expectancy
• Well established comorbidities associated with psoriasis include Heart Attack, Stroke, CV death, Metabolic syndrome, Diabetes, Psoriatic arthritis, Mood Disorders (anxiety, depression, suicide), Crohn’s Disease, and T cell lymphoma (rare)
• Emerging comorbidities associated with psoriasis include Sleep apnea, Nonalcoholic steatohepatitis (NASH), Chronic obstructive pulmonary disease (COPD), Adverse infectious disease outcomes, Chronic and end stage renal disease, Peptic ulcer disease
• Perform a skin biopsy if the diagnosis is not certain or if the patient is not responding appropriately to treatment. Connective tissue diseases and cutaneous T cell lymphoma can mimic psoriasis and may be exacerbated by psoriasis treatments
• Putting a patient on an immune suppressive medication? Be sure to consider age appropriate cancer screening and vaccinations to lower the risk of complications