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Information presented at American Academy of Dermatology’s 70th Annual Meeting by Joel M. Gelfand, MD, MSCE, FAAD, assistant professor of dermatology and epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
Psoriasis is a chronic skin condition characterized by raised, red, scaly, plaques that can itch, crack and bleed. Psoriasis can be localized and affect only limited areas of the skin, such as the scalp or elbows, or it can involve the skin on the entire body. The condition can be painful, disfiguring and disabling. It is believed to occur due to an interaction of multiple genes, the immune system and the environment.
Research has shown that excessive inflammation is a critical feature of psoriasis. Because chronic inflammation also is a characteristic of insulin resistance, obesity, abnormal cholesterol levels and cardiovascular disease, emerging studies have linked these serious medical conditions with psoriasis. As a result, it is important for psoriasis patients--particularly those with severe cases--to monitor their health very closely for signs of these diseases.
Cholesterol concerns. Studies using innovative techniques to evaluate cholesterol composition and function have shown that psoriasis patients have LDL (or “bad”) cholesterol that consists of smaller and denser cholesterol particles, a pattern observed in patients with diabetes. These smaller and denser particles are more likely to promote hardening of the arteries and cause heart attacks. Gelfand added that for the first time it has been demonstrated that psoriasis patients also have impaired function of HDL (or “good”) cholesterol, which may not allow HDL to remove cholesterol from the cells in the arteries.
Metabolic syndrome concerns. Studies involving more than 4,000 patients with psoriasis have shown that the more body surface area of skin that is affected by psoriasis, the higher the likelihood that the patient will have metabolic syndrome--a group of cardiovascular risk factors of obesity, hypertension, insulin resistance and increased triglycerides. Gelfand explained that this study suggested a “dose-response” effect of psoriasis, whereby increasing skin disease severity was more strongly associated with these potentially serious metabolic disorders.