Certain health conditions are more common in people with psoriasis than in the general population. Some people may have these conditions before their psoriasis diagnosis, while others may develop them as a result of the skin condition or its treatment.

Psoriasis is a chronic condition that causes inflammation and the accelerated production of skin cells. Skin builds up more quickly than it can shed, causing patches of thickened, scaly skin that can crack, bleed, and itch — as well as other symptoms.

Comorbidities and Complications

When a person has more than one health condition at the same time, these conditions are known as comorbidities. On the other hand, complications refer to medical problems that occur from another condition or treatment.

Age is an important factor in whether a person develops any comorbid conditions. Generally, the longer a person lives, the more likely they are to have illnesses. The National Psoriasis Foundation suggests visiting your primary care provider regularly to make sure you are healthy and to screen for any underlying conditions. It’s also important to manage your psoriasis with proper treatment, because this can lower your risk of developing comorbidities.

Keep reading to learn about nine medical conditions related to psoriasis.

1. Psoriatic Arthritis

Psoriatic arthritis (PsA) affects around 30 percent of people with psoriasis, making it the most common comorbidity for the condition. PsA is a chronic autoimmune disease that affects the joints — specifically where the tendons and ligaments attach to the bone.

Common psoriatic arthritis symptoms include:

• Swollen fingers and toes
• Pain and swelling around tendons
• Morning stiffness
• Fatigue
• Limited range of motion
• Uveitis (inflammation inside the eye)

PsA tends to develop in people between the ages of 30 and 50. In many cases, it starts around 10 years after psoriasis develops. However, some people can develop PsA before noticing psoriasis. There’s little connection between the severity of psoriasis and the severity of PsA.

2. Cardiovascular Disease

Compared to people without psoriasis, those with the condition are more likely to develop cardiovascular disease — that is, disease related to the heart and blood vessels. This is because the immune system is not regulated properly in psoriasis, which can result in inflammation throughout the entire body, including the heart and vascular system (blood vessels, e.g., arteries and veins). You are more likely to have comorbid cardiovascular disease if your psoriasis developed at a young age and is more severe.

The inflammation from psoriasis can lead to the development of atherosclerosis (fatty buildup in the arteries), which can further lead to heart attack or other cardiovascular complications, such as:

• Ischemic heart disease
• Stroke
• Peripheral vascular disease
• Arrhythmia (irregular heartbeat)
• Pulmonary hypertension (high blood pressure in the lungs)

3. Metabolic Syndrome

Metabolic syndrome refers to a set of conditions that increase the risk of stroke, heart disease, and type 2 diabetes mellitus. The set of conditions includes:

• Hypertension (high blood pressure)
• Dyslipidemia (abnormal cholesterol levels)
• Insulin resistance
• Obesity (characterized by high body mass index, or BMI)

A 2016 research review from the journal Anais Brasileiros de Dermatologia found that people with psoriasis have a 14 percent to 40 percent chance of developing a metabolic syndrome. By comparison, researchers estimate that in the United States, metabolic syndrome affects around 22 percent of adults, according to research from JAMA. The severity of psoriasis also correlates with metabolic syndrome, with metabolic issues more prevalent in those with more severe psoriasis.

Obesity has been shown to increase levels of inflammation in the body, and it can also affect how well therapies work in treating psoriasis. The 2016 Anais Brasileiros de Dermatologia research review found that weight loss coupled with biologic treatment — specifically, tumor necrosis factor-alpha (TNF-alpha) inhibitors such as infliximab (Remicade), etanercept (Enbrel), and adalimumab (Humira) — helps control psoriasis better than treatment in those who are overweight or obese.

4. Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is caused by chronic inflammation in the stomach, intestines, and colon. Ulcerative colitis and Crohn’s disease are IBDs and can cause:

• Abdominal pain
• Diarrhea
• Bleeding from the rectum
• Loss of appetite
• Weight loss

Many studies have found similarities between psoriasis and IBD, such as shared common genes and the same signs of inflammation. In fact, one study found that over time, people with psoriasis were 153 percent more likely to develop Crohn’s and 71 percent more likely to develop ulcerative colitis when compared to individuals without psoriasis.

5. Celiac Disease

Celiac disease is another autoimmune disease that occurs in people with psoriasis. When a person with celiac disease eats gluten, their immune system recognizes the gluten as foreign and attacks it. This causes damage to the person’s small intestine, and they can’t absorb nutrients from food as well. Research shows that people with psoriasis are three times as likely to develop celiac disease as compared to people without psoriasis.

6. Systemic Sclerosis

Systemic sclerosis is a rare autoimmune disease that is similar to rheumatoid arthritis. It can cause swelling of the fingers and joints because the body produces too much collagen (a substance found in muscles, tendons, and joints). Systemic sclerosis can also cause damage to the lungs, kidneys, heart, and gastrointestinal tract due to increased inflammation.

A 2019 study from Journal of Clinical Medicine found that people with psoriasis are more than twice as likely to have systemic sclerosis when compared to individuals not living with psoriasis.

7. Nonalcoholic Fatty Liver Disease

“Nonalcoholic fatty liver disease (NAFLD)” is a term used for a number of liver conditions that are not caused by drinking alcohol. It can develop in people with psoriasis, especially in those who also have metabolic syndrome. Many studies suggest that those with psoriasis are 1.5 to three times more likely to have NAFLD.

Researchers have found that people with psoriasis and NAFLD have more severe skin disease and have lived with psoriasis for longer, according to the Indian Journal of Dermatology, Venereology and Leprology. This group was also more likely to have other complications, such as diabetes, hypertension, and chronic obstructive pulmonary disease (COPD).

8. Certain Types of Cancer

People with psoriasis are also at an increased risk for developing certain types of cancer, due to the systemic inflammation from the skin condition. In addition, certain treatments for psoriasis that affect the immune system have also been found to increase the risk of developing cancer — specifically lymphoma (blood cancer).

Research shows that people with psoriasis are 18 percent more likely to develop cancer compared to healthy individuals. This risk is 22 percent for people with severe psoriasis.

Types of cancer more common in those with psoriasis include:

• Skin cancers, specifically squamous cell carcinomas and basal cell carcinomas
• Lymphoma
• Esophagus cancer
• Bladder cancer
• Liver cancer
• Pancreatic cancer

9. Depression and Anxiety

Depression has long been linked to psoriasis, caused by the skin condition’s impact on the personal and social lives of those living with it. The two conditions also share several risk factors, including genetic aspects, low melatonin and vitamin D3 levels, and inflammation. Many people with psoriasis also report having low self-esteem and anxiety in social situations, which can make depression worse.

Symptoms of depression can include:

• Tiredness
• Irritability
• Changes in sleeping and eating patterns
• Reduced interest in things you once liked
• Feelings of sadness, hopelessness, or emptiness
• Trouble focusing or sitting still
• Difficulty making decisions
• Feels of worthlessness or guilt
• Suicidal thoughts

If you are experiencing any of these symptoms, talk to your doctor about treatment options. It is important to take care of yourself both mentally and physically. Options include:

• Therapy or counseling
• Medication, such as antidepressants
• Support groups or group therapy
• Regular exercise

The Impact of Comorbidities

Some comorbidities can affect your health and quality of life with psoriasis more than others. If you do have any of these underlying health conditions, it’s important to speak with your dermatologist or primary care provider about how to manage and treat them. Addressing these conditions can help you lead a healthier, more comfortable life.

Find Your Team Today

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 118,000 members ask and answer questions, share their stories, and provide much-needed support.

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