Psoriasis can be unattractive and uncomfortable at times, but it’s not usually life-threatening. For about 80 percent of people with this chronic inflammatory skin disease, the condition is mild, and the itching and scratching can probably be controlled with good skin care and a commitment to your treatment plan.
Yet psoriasis can be a serious health threat for some people. In a study published in May 2006 in the Journal of Dermatological Treatment, research conducted by Wake Forest Baptist Medical Center from 1999 to 2001 found an average of about 30 deaths a year that could be attributed to psoriasis.
Jerry Bagel, MD, director of the Psoriasis Treatment Center of Central New Jersey in East Windsor, believes the number of deaths each year from psoriasis and psoriasis complications may be more like 50 to 100.
The Threat of Erythrodermic Psoriasis
Erythrodermic psoriasis is the most serious form of the disease. With erythrodermic psoriasis, at least 80 percent of your skin’s surface is affected by redness, inflammation, and psoriasis plaques, giving the appearance of a severe burn. It can come on suddenly or evolve from plaque psoriasis, the most common form of the disease.
“Less than one-tenth of 1 percent of all psoriasis is erythrodermic,” Dr. Bagel says. But while extremely rare, erythrodermic psoriasis carries with it the risk of death.
Triggers of erythrodermic psoriasis include:
- Severe sunburn
- Medication such as lithium or antimalarial drugs
- Strong coal tar products
- Overuse of powerful corticosteroids
- Abrupt withdrawal of psoriasis medication
Erythrodermic psoriasis increases your chances of death because it increases blood flow to your skin.
“With so much blood going to the skin, you don’t have enough blood to nourish your heart,” Bagel says. If you have an attack of erythrodermic psoriasis, and especially if you have any underlying heart conditions, you can have a fatal heart attack.
Erythrodermic psoriasis also can lead to loss of protein and fluids, resulting in life-threatening infections, pneumonia, and congestive heart failure. If you have erythrodermic psoriasis and experience a flare, seek treatment immediately. You may need to be hospitalized.
Other Serious Psoriasis Complications
Evidence is mounting that people with moderate to severe psoriasis are at greater risk for metabolic syndrome, Bagel explains.
Metabolic syndrome is the name given to a group of risk factors for heart disease and other serious health problems. Those risk factors include being overweight and having excess fat around your midsection, having high blood pressure, having high cholesterol, and being insulin resistant.
The health threat is an escalating one, too — the more metabolic risk factors you have, the greater your chances of having a heart attack or stroke, or of developing diabetes. Diabetes that’s not under control puts you at risk for developing kidney failure, infection, and other life-threatening diseases.
When a group of researchers analyzed results from the 1988 to 2012 National Health and Nutrition Examination Survey, which involved 6,549 people 20 to 59 years old, they found almost twice the incidence of metabolic syndrome (43 percent) among people who had psoriasis than among those who didn’t (23 percent).
A study published in October 2011 in the Journal of Pediatrics found that children with psoriasis have a greater likelihood of developing metabolic diseases, especially if they're obese, and that teens with psoriasis have higher cholesterol levels, regardless of their weight.
High cholesterol levels can lead to clogged arteries and, in turn, heart attacks and strokes. The findings suggest that the increased risk for heart disease among those with psoriasis can start at an early age, and that people and their doctors need to take the link between heart disease and severe psoriasis seriously.
Also, a Danish study published in March 2011 in the Journal of Internal Medicine looked at nearly 50,000 heart attack patients, and found that people who also have psoriasis are more likely to die from cardiovascular disease or have repeated heart attacks and strokes than those without psoriasis.
Research published in October 2012 in the Journal of the American Academy of Dermatology investigated the link between heart disease and psoriasis and found that people with severe psoriasis had a 53 percent greater chance of having a heart attack, having a stroke, or dying from heart disease than the general population.
Protect Yourself From Psoriasis Health Risks
Because erythrodermic psoriasis can be triggered by poorly controlled psoriasis, you want to do everything you can to keep a tight rein on psoriasis.
Be sure you’re taking the proper medication in the proper dosage, and never stop treatment without discussing it with your doctor first. Come prepared with a list of any other medication you take, so your doctor can decide which psoriasis medication is best for you.
If you have moderate to severe psoriasis, maintaining a healthy weight and cholesterol levels will help reduce heart disease and diabetes risk factors. These tips will help:
1. Eat a diet rich in colorful vegetables and fruits.
2. Choose foods rich in whole grains and fiber over processed foods.
3. Have heart-healthy fatty fish such as salmon or mackerel at least twice a week.
4. Limit your daily fat intake to 30 percent of your total calories, and choose healthy unsaturated fats such as olive and canola oil.
5. Avoid foods with trans fats.
6. Choose the low-fat or fat-free versions of cheese, milk, yogurt, and other dairy products.
7. Season foods with herbs and spices rather than salt.
8. Exercise at a moderate to intense level for at least 30 minutes, five or six times a week.
Be sure to let your primary care doctor know you have psoriasis and have your blood pressure, blood sugar, and cholesterol levels checked periodically — these are all important indicators of heart health. Protect your health by not smoking, and drink only moderate amounts of alcohol — one drink a day if you’re a woman and two if you’re a man.
Psoriasis should not be a life-threatening disease. Talk with your doctor about how to best keep your skin condition under control and be diligent about your overall health.