I remember seeing television ads as a child proclaiming “the heartbreak of psoriasis.” And lately, I’ve been seeing ads for new medications that can treat this condition. I’ve always thought of psoriasis as an annoying skin condition, but didn’t realize that it’s linked to inflammation. It’s also linked to a higher risk of Type 2 diabetes. Read on to learn more.
What is psoriasis?
According to the Psoriasis Foundation, “psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin.” These patches are usually found on the elbows, knees, and scalp, but they can be anywhere on the body. The dry, flaky skin is a result of a rapid buildup of skin cells, triggered by inflammatory chemicals. Psoriasis is a fairly common condition, affected between 1% and 3% of the U.S. population. It can also occur in children, although it’s more common in people between the ages of 15 and 35.
What are the signs and symptoms?
Psoriasis can appear as red bumps that blend into each other, forming scaly patches, called plaque psoriasis. Again, they’re more likely to form on the elbows, knees, lower back, or scalp, or on areas that are exposed to a lot of friction. These patches are silvery in color and are often itchy and painful. One way that psoriasis is diagnosed is if pinpoint spots of blood form after pulling off one of the patches — this is called the Auspitz sign.
Psoriasis can also appear in the genital regions, between the buttocks, or on the back of the knees, called inverse psoriasis. This shows up as red, smooth, shiny lesions.
Guttate psoriasis appears as small, dot-like lesions that are often triggered by a strep infection, such as strep throat. This type of psoriasis can start in childhood or in young adulthood.
Pustular psoriasis is noted by white blisters (pustules) on the skin that are filled with pus. These pustules generally occur on the hands or feet.
Psoriasis can affect the joints, causing a condition called psoriatic arthritis (for you golf fans, in 2010, Phil Mickelson revealed that he has this condition).
What causes psoriasis?
Scientists aren’t exactly sure what causes this skin condition, but it’s thought that the immune system and genetics play a role. About 10% of Americans inherit genes that cause psoriasis, although only 2% to 3% of the population will develop it. It’s also thought that T cells, which are immune system cells that normally fight off invaders, attack healthy skin cells by mistake. This “attack” is usually triggered by certain factors, including infections, skin injuries, stress, smoking, drinking too much alcohol, cold temperatures, other autoimmune disorders, such as rheumatoid arthritis, and even some medications, like beta blockers and lithium. Women who have psoriasis are more likely to have a flare-up after the birth of a child.
What is the link between psoriasis and Type 2 diabetes?
A Danish study conducted in 2013 involving more than 52,000 adults and children age 10 and older who had psoriasis found that the subjects had a higher risk of getting Type 2 diabetes compared to the rest of the population. The more severe the psoriasis, the higher the chance of developing diabetes.
And in another study out of the University of Pennsylvania, researchers compared 100,000 people who had psoriasis to 430,000 people without it. Those who had severe psoriasis were roughly twice as likely to develop Type 2 diabetes as people without psoriasis. This risk was higher even in the people with psoriasis who didn’t have other diabetes risk factors, such as obesity.
Both Type 2 diabetes and psoriasis increase inflammation in the body. The inflammation caused by psoriasis raises the level of an insulin-like growth factor that’s linked to diabetes. In addition, psoriasis is linked with insulin resistance, obesity, heart attack, high blood pressure, and high cholesterol.
How is psoriasis treated?
There’s no cure for psoriasis, but it can be managed. Treatment may consist of a combination of factors, including medications (topical, oral, or injections), light therapy, and lifestyle factors. In terms of medication, your doctor will likely start with a milder choice (depending on the severity of the condition), such as a topical ointment and phototherapy. If the condition isn’t effectively managed by either of these, he or she will progress you to a more potent medication that, while effective, can have serious side effects.
In the meantime, you can make changes to your lifestyle to help better manage psoriasis:
• Lose weight if you are overweight. Some studies have found that weight loss improves psoriasis. And it will help you better manage diabetes, too.
• Take good care of your skin. Avoid getting sunburn by wearing sunscreen and wearing a hat when you’re outdoors. Try to avoid cuts and scrapes to your skin when doing outdoor activities or playing sports. Take daily baths and keep your skin moisturized.
• Avoid infection. Upper respiratory infections such as strep throat and tonsillitis, can trigger a psoriasis flare-up, so do your best to avoid them by practicing good hygiene (wash your hands often!).
• Limit alcohol. Alcohol can interact with some psoriasis medications.
• Eat healthy foods. Eating a healthful diet will help you better manage your weight and your diabetes, and can keep your immune system in good shape, too. While there isn’t strong evidence to support the role of diet in managing psoriasis, there could be a link between eating and avoid certain foods to help control inflammation.
-Foods that could trigger inflammation: fatty foods; red meat; processed and refined foods; dairy products
-Foods that might reduce inflammation: cold-water, fatty fish; flaxseed; pumpkin seeds; walnuts; fruits; and vegetables
While psoriasis can’t be cured, like diabetes, it can be managed. Work with your health-care team to find the right treatments and approaches for you. For more information about psoriasis, visit www.psoriasis.org.