Even mild psoriasis can undermine self esteem and disturb personal relationships. A 1998 survey by the US National Psoriasis Foundation of its 40,000-strong members revealed that the disease had a profound physical, emotional and social impact on their quality of life. Indeed, one 1999 study (Rapp et al) reported that test scores measuring the physical and mental impact of psoriasis were comparable to those seen in cancer, arthritis, hypertension, heart disease, diabetes and depression.

A new population-based study on psoriasis co-morbidities has revealed that psoriasis is a marker of underlying systemic disease. The study indicates that psoriasis patients have an increased prevalence of obesity, dyslipidaemia, and diabetes. As well, psoriasis patients are more frequently associated with psoriatic arthritis, Crohn's disease, pustular psoriasis, and have an increased risk of cardiovascular disease. An increased incidence of depression is also found in all psoriasis patients, even those with relatively mild symptoms.

More disturbing, the study shows that severe psoriasis is associated with an increased risk of death: patients with severe psoriasis have a 50% increased risk of death compared to patients with no psoriasis. However, patients with mild psoriasis are not associated with an increased risk of death.

The study from which this information was derived: “The risk of mortality in patients with psoriasis: results from a population-based study. ”
Gelfand JM, Troxel AB, Lewis JD, Kurd SK, Shin DB, Wang X, Margolis DJ, Strom BL. Arch Dermatol. 2007 Dec;143(12):1493-9.

The US National Psoriasis Foundation has recommended that all clinicians should screen psoriasis patients for the co-morbities: obesity, cardiovascular disease, depression, infections, malignancies, and psoriatic arthritis.

The information above was summarized and provided by Dr. Stuart Maddin, Department of Dermatology and Skin Science, University of British Columbia.