Psoriasis Patients Need To Be Checked For Multiple Concurrent Diseases

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Main Category: Eczema / Psoriasis
Article Date: 11 Mar 2008 - 11:00 PST

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Psoriasis patients should be routinely screened for the presence of potentially serious co-morbidities associated with the disease, investigators said here at a journalists workshop.

"Psoriasis is usually viewed as a benign skin condition, however it's becoming increasingly clear that psoriasis is a systemic immune-mediated disorder which has important disease associations with significant morbidity and an increased risk of mortality," Dr. Wayne P. Gulliver, chairman of the dermatology division at Memorial University of Newfoundland in St. John's, Canada, noted.

Dr. Gulliver and co-workers are examining the association between psoriasis and co-morbidities using data from 525,000 individuals drawn from four Canadian population registries.

Results to date show increased rates of arthritis, heart disease, diabetes, and hypertension in psoriasis patients versus the general population.

In addition, 68 percent (2,220 of 3,228) patients required hospitalization at least once during the past ten years. Of hospitalized patients, about 56 percent had an associated cardiovascular co-morbidity and 18 percent had diabetes, much higher than the roughly four percent prevalence rate of these "these common complex diseases" in the general population.

Psoriasis patients were also more likely to die of cardiovascular disease than the general population (44 percent versus 36 percent).

The research showed that Canadians with psoriasis usually die about ten years earlier than Canadians without psoriasis (68.8 years versus 77.4 years for males and 72.2 years versus 82.5 years for females).

An earlier age of psoriasis onset is also a negative prognostic factor. That is, individuals who develop the condition before they reach 25 years of age have a life expectancy that is decreased by 25 to 30 years.

Finally, Dr. Gulliver said that early data suggest that certain polymorphisms - HLA-cW6 - may increase the likelihood of psoriasis co-morbidities.

While common pathogenetic mechanisms may, in part, explain why psoriasis patients have such a high rate of associated co-morbidities, under-treatment of psoriasis may also be a contributor, he suggested. "It has been widely established that treating the immune-mediated inflammation may decrease the risk of co-morbidities such as cardiovascular disease."

"A diagnosis of psoriasis should be a tip-off to the physician that the patient is at increased risk of multiple potentially serious concurrent diseases," Dr. Gulliver said. Accordingly, he recommended that psoriasis patients have their lipids checked for dyslipidemia, their glucose tested for diabetes, and their blood pressure measured for hypertension, and they should also ECG to look for possible heart disease."

Psoriasis affects roughly 0.1 to 3.0 percent of the population worldwide.

Memorial University of Newfoundland

Written by: Jill Stein
jillstein03@gmail.com


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