Psoriasis is a lifelong, autoimmune inflammatory disease. It often appears as a skin condition, but it is a systemic condition that can affect many parts of the body.

There are many different types of psoriasis, and it is a complex condition.

As scientists learn more about inflammatory conditions and how they affect people, they are also establishing more links between conditions that have different diagnoses.

In addition, psoriasis poses lifestyle challenges that can be difficult to cope with. This can lead to additional symptoms, such as depression.

Due to various factors — including disparities in access to treatment, and the non-red color of the psoriasis plaques — it may take longer for people with black or brown skin to receive medical attention for psoriasis. This may delay the start of treatment and increase the risk of experiencing complications.

Read on to find out more about some of the problems that may occur alongside this condition.

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People with psoriasis are more likely to have antibodies for celiac disease, suggesting that there may be a link between the two.

Celiac disease affects around 1% of the general population, but it may be present in up to 4.3% of those with psoriasis.

People with celiac disease can experience a severe reaction when they consume gluten.

Both celiac disease and psoriasis appear to stem from dysfunction in the immune system. Some people find that avoiding gluten helps to reduce the symptoms of psoriasis.

Researchers who published a review of studies in the Archives of Dermatology in 2017 suggested a number of conditions that are common in people with psoriasis may indicate a link with the gastrointestinal system.

The authors of a review published in 2014 concluded that a gluten-free diet may help some people with psoriasis. But they called for more research to confirm a link.

People with psoriasis who are considering giving up gluten should talk with a doctor first, as whole grains can contain valuable nutrients, and a gluten-free diet may not be suitable for everyone.

Some studies have suggested that people with psoriasis are more likely to develop problems with mucous membranes in the oral cavity, such as fissures in the tongue and lesions in the gums and cheeks.

Scientists have not established a specific link between psoriasis and oral problems, but research suggests that tongue fissures, for example, appear to be more common in those with psoriasis. Why they occur together also remains unclear.

Psoriasis and mouth problems could stem from similar genetic factors, or they might result from exposure to similar triggers, such as stress and alcohol.

Scientists have looked at possible links between psoriasis and inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis.

Studies have suggested that people with psoriasis and their family members may be more susceptible to these conditions.

Psoriasis and IBD have various genetic factors in common.

Studies have found that vitamin D deficiency is often present at the onset of some autoimmune diseases.

Some experts recommend taking vitamin D supplements to reduce the symptoms of psoriasis.

One observational study involving 561 people, of whom 170 had psoriasis, found that people with psoriasis had significantly lower levels of vitamin D than those without the condition. This study took place in South Italy, and all of the participants were white. The researchers suggested that vitamin D levels could impact the length of time symptoms last.

But they note that the association between vitamin D and psoriasis is “controversial.”

Another study published in 2018 looked at 61 people with psoriasis, and 61 people without, in a hospital in Deralakatte, south India. The researchers found no correlation between vitamin D levels and the severity of psoriasis symptoms in the two groups.

Some studies have indicated that psoriasis may increase the risk of cancer overall, and also some specific types of cancer, including oral, esophageal, liver, and pancreatic cancer.

One reason may be the use of systemic medications in treatment. These drugs affect the whole body.

Other underlying reasons may include genetic factors and the impact of psoriasis on the individual’s lifestyle. More research is necessary to confirm a link.

Among people with psoriasis, there is a higher risk of some of the symptoms of metabolic syndrome, including heart problems, diabetes, fatty liver disease, and obesity.

Experts do not know what might link these conditions with psoriasis. There may be common genetic factors, they may share similar environmental triggers, or there may be a combination of reasons.

People with moderate to severe psoriasis should undergo testing for these conditions so that they can receive preventive treatment if necessary.

Some types of psoriasis can affect body temperature regulation. This can have an impact on internal organs, such as the heart and the kidneys, according to the National Psoriasis Foundation.

The skin is important for keeping the body temperature stable, and problems that affect the skin can also affect temperature, especially with more severe forms, such as erythrodermic and pustular psoriasis.

Pustular psoriasis is a severe form of psoriasis that can appear in people who already have psoriasis.

One type, known as Zumbusch psoriasis, can lead to severe erythroderma and skin scaling.

In a 2015 case study of a person with pustular psoriasis, researchers noted that the condition can increase the risk of the following life threatening complications:

The person who was the focus of the study had the following symptoms:

  • pustular skin lesions
  • pitted nail beds
  • fever and chills
  • muscle weakness
  • a rapid heartbeat
  • tremor
  • difficulty breathing
  • an over-accumulation of fluids, or edema

A person with pustular psoriasis may need to spend time in the hospital until treatment normalizes their fluid levels, chemical balances, heart function, and skin condition.

Up to 30% of people with psoriasis may develop psoriatic arthritis (PsA).

It usually appears between the ages of 30–50 years.

While 85% of people with this condition first have skin symptoms, it can occur before or without dermatological symptoms.

Symptoms include:

  • fatigue
  • pain and swelling over the tendons
  • swollen fingers and toes
  • reduced mobility
  • stiffness and pain in one or more joints
  • pitted nails that may look as if they have a nail fungus
  • uveitis, a type of eye inflammation

There are also different types of PsA, including:

Anyone with psoriasis who has joint pain or stiffness should talk with their doctor. Early treatment can reduce the risk of permanent joint damage.

Complications

Eye problems: According to the National Psoriasis Foundation, people with PsA are more likely to develop uveitis, an inflammatory eye disease.

Hearing loss: A 2014 Spanish study looked at the risk of hearing loss in 60 people with PsA and 60 people without PsA.

The researchers found that 60% of those with PsA had some degree of hearing loss, compared with only 8.3% of those without the condition. They concluded that PsA may lead to damage in the inner ear.

Eye complications, such as uveitis, are associated with psoriatic arthritis. But research suggests that 7–20% of people with psoriasis have uveitis, and some people may have more than one eye problem.

People with psoriasis may experience the following eye complications:

People with psoriasis should see an eye doctor for regular checkups.

Parkinson’s disease is a neurodegenerative disorder that affects the brain. This disease causes chronic inflammation in the neuronal tissue, eventually causing gait issues, balance problems, and tremors.

People with psoriasis may be more at risk of developing Parkinson’s disease because of the inflammation in the neuronal tissue.

Chronic kidney disease appears to be more common among people with psoriasis.

Scientists reporting in 2016 described this as “logical,” because psoriasis has links with cardiovascular disease, and kidney disease shares the same risk factors.

In addition, the treatments people use for psoriasis are likely to have a toxic effect on the kidneys.

Living with psoriasis can be difficult, and it can have emotional and social consequences.

In a review published in Dermatology and Therapy in 2013, researchers describe psoriasis as a “common, long-term skin condition associated with high levels of psychological distress and considerable life impact.”

People who have visible lesions may feel embarrassed by their appearance. This can lead to isolation, depression, and anxiety.

This can affect areas of life such as:

  • relationships
  • employment
  • leisure and social activities

But there may also be physiological reasons for the psychological impact of psoriasis.

Scientists have found evidence of adrenal and pituitary involvement, which could lead to a hormonal imbalance. This imbalance could impact both the skin and the psychological well-being of a person with psoriasis.

Stress and worry, in turn, can make symptoms worse.

Anyone with psoriasis who is experiencing signs of depression or low mood should talk with a doctor about their concerns.

As doctors increasingly come to understand the mental health challenges that people with psoriasis face, more effective treatment will hopefully become available.

Psoriasis is a complex condition with a wide range of possible complications and comorbidities.

When a person is familiar with the possible problems that can arise, it will be easier for them to explain to their doctor how they feel and to seek help.

Getting an early diagnosis for psoriasis may also help prevent some complications. An early diagnosis can lead to prompt treatment, which may be more effective in managing the condition. Anyone who believes they may have psoriasis should speak to a healthcare professional.

Treatment is available that can help to reduce many of the symptoms and complications of psoriasis and to improve a person’s quality of life.