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Live Blog: Implications of Psoriasis Comorbidities for Clinical Practice – Joel Gelfand, MD, MSCE

 
In this live blog from the 12th Annual SDPA conference in Indianapolis, Joel Gelfand, MD, spoke on the topic of “Implications of Psoriasis Comorbidities for Clinical Practice.” Here are some of the highlights. 

In his lecture, Dr. Joel Gelfand discussed the comorbidities of psoriasis.  He addressed psoriasis and obesity, smoking, alcohol, lymphoma and infection.

For patients with severe psoriasis, he presented a 50% increased risk of mortality, 5 years of life lost, and death by cardiovascular disease, infection, and cancer. If psoriasis is treated, the cardiovascular events are lowered.

Obesity and Psoriasis
It’s estimated that 1 in 3 cases of psoriasis is attributable to obesity.  This is a preventable risk factor. Being overweight can raise the risk for psoriasis. Studies have shown that psoriasis can be improved with dietary changes. Diabetes often comes with obesity and goes undiagnosed often. For obese patients, you can screen for diabetes or lipid disorders. Even knowing that they are at risk for diabetes, can jump start their move for healthier choices.

Smoking and Psoriasis           
Heavy smoking is linked to psoriasis. Pustular psoriasis will be seen from the most dedicated smokers.

Alcohol and Psoriasis
Excess alcohol intake is also associated with psoriasis, particularly in males. Patients with psoriasis who continue to consume alcohol will be categorized as noncompliant.

Lymphoma and Psoriasis
There are conflicting results as to whether psoriasis and/or its treatment increases the risk of lymphoma. There is a strong association of psoriasis with cutaneous t-cell lymphoma, which may progress rapidly with immuno-suppression. 

While much money is spent on new developments and treatments for psoriasis, the AAD recently updated the guidelines regarding knowledge gaps in the area of psoriasis, particularly when it comes to cormorbidities. 

Image: J. McPherskesen