Psoriasis is a disorder of the skin, which develops due to improper function of the immune system and environmental factors.
Though its symptoms and signs are limited to the skin, scalp, nails, and joints the complications of untreated psoriasis can run deep and can be severe posing serious health risks especially if this condition remains untreated.
There are several adverse medical consequences on health that can arise due to psoriasis. Some resolve easily while some are long-standing. These risks increase significantly if you do not treat this condition.

Systemic complications are usually long-term and should be treated promptly. They include diabetes, hypertension, cataract of the eye, heart problems, Parkinson’s disease, and obesity.

Outlook of Psoriasis

That psoriasis is a lifelong companion is a fact because there is no permanent cure. The course of this skin condition is marked by remissions and relapses. Relapses often end in remissions and clearance of this skin disease on its own.

At times, the plaques can persist for years. Though the skin cells multiply at a very rapid rate, they do not mutate and form cancer cells. However, the risk of skin cancer does exist in patients with psoriasis.

Health complications

The presenting side effects of psoriasis depend on the severity, location, and type.

Local skin complications

Due to severe and chronic itching, scratching of the psoriatic skin can cause it to become thickened, inflamed, and infected.

Folate deficiency

Psoriasis patients are at a greater risk of developing folate deficiency. Folate is a naturally occurring nutrient of the vitamin B complex family and serves important uses in the body.

It is useful for the formation of new blood cells, preventing birth defects and high levels of homocysteine.

Elevated homocysteine levels increase the risk of cardiovascular disease. The deficiency of folate due to psoriasis can nullify these benefits of folates.

Eye complications

According to the International Journal of Contemporary Medical Research (IJCMR), a complete eye examination should be done in every patient suffering from psoriasis.

Ocular manifestations include cataract, conjunctivitis, dry eyes, and uveitis.

Parkinson’s disease

Patients with psoriasis are at a greater risk of developing Parkinson’s disease. This is because of the adverse effect of chronic inflammation on the tissue of the nervous system.

 Obesity and diabetes

It is found that in patients with psoriasis, there is an increased incidence of obesity and diabetes. There is no confirmation but a genetic link cannot be ruled out.
People who have moderate to severe psoriasis should be periodically screened and tested to rule out the presence of these conditions.

Cardiac complications

The cause of cardiac complications could lie in the fact that people with psoriasis are more likely to develop atherosclerosis than people who do not have this disease.

The underlying cause could be chronic inflammation, which is present in such patients.

Some psoriasis medications can cause increased cholesterol levels. This can harden the arteries and make a heart attack even more likely.

Research suggests that these patients are more prone to develop some form of cardiovascular disease.

Skin cancer

Severe psoriasis being treated with systemic therapy presents an increased risk of cancer, particularly skin cancer and lymphomas.

However, the risk of non-melanoma skin cancer is high in these patients, regardless of the treatment given.

Psoriasis and impaired temperature regulation

This effect on the skin is seen more in the erythrodermic or exfoliative type of psoriasis. The skin of the whole body becomes red and inflamed resulting in loss of the skin function of regulating body temperature.

Psychological complications

Living with this condition’s ugly appearance and the truth of its outcome, the patient undergoes psychological changes, which have long-term complications.

These emotional and social effects result in low self-esteem and even depression.

Having these ugly and itching plaques on the body does make him a stray and he or she can no longer socialize. He withdraws into his own and this only adds to his anxiety and stress.

Severe relapses make him frequently stay absent from work or school and can result in job loss. Expenses of treatment are high and losing a job only adds to the stress.

In relation to the psychological effects, a national survey conducted in the USA found that in persons with severe psoriasis,

  • 20% lost their jobs because of this disease,
  • 25% lost on an intimate relationship because of their psoriasis.
  • 43% said that they could not make new friends because of this condition.
  • 83% of these patients were dissatisfied with the treatment they received.
  • Another study indicated that 75% of psoriatic patients lost their self-confidence.
  • One other study indicates that 8% of persons with psoriasis felt that life was not worth living.

Patients of psoriasis must have help in this regard and should join support groups. This will remove the feeling of isolation and help in living with this condition.

Alcohol, smoking, and psoriasis

This is an aftermath of the low self-esteem and depression associated with psoriasis. Due to chronic anxiety and stress, the psoriatic patient turns to alcohol and smoking to drown his emotional sorrow.

Studies have found that mortality in psoriasis is contributed significantly by heavy drinking. In addition, to make matters worse, alcohol and smoking contribute as triggers to the development and relapses of this conditiion.

Von Zumbusch Psoriasis

This is a form of psoriasis, which is a combination of pustular and erythrodermic type of psoriasis and is considered a complication because it can make the patient very ill and can at times be fatal.

The onset of von Zumbusch pustular psoriasis is abrupt. The skin becomes red, painful, and tender and in a matter of hours, pustules appear. They dry and peel off within 24 to 48 hours leaving a smooth and glazed skin.

A fresh crop of pustules may again appear. Eruptions come in waves and can last for days or weeks.

Von Zumbusch pustular psoriasis is accompanied by fever with chills, dehydration due to loss of body fluids, electrolyte imbalance, fatigue, anemia, weight loss, and muscular weakness.

Immediate medical attention with hospitalization is required to replenish the lost body fluids and electrolytes and to ward off infection with antibiotics.

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