Psoriasis prognosis

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Psoriasis is a benign, chronic, inflammatory disease that usually involves outbreaks, periods of flare‑ups, and remission.

The prognosis of this disease is the same as for the general population, except in cases where there are associated cardiovascular risk factors or other diseases independent of psoriasis. However, the quality of life of patients with extensive lesions, or during flare‑ups, can be significantly affected.

Acute complications

Although acute complications are very rare, the following are considered variants of psoriasis:

  • Generalized pustular psoriasis or Von Zumbusch‑type. This can be related to certain trigger factors (drugs, hypocalcaemia, stressors, and infections) and presents as small sterile pustules that appear rapidly, anywhere on the body, even the nails. It is accompanied by systemic symptoms (fever, leukocytosis, elevated acute phase reactants, etc.) and requires intensive treatment to avoid dehydration and severe infections. After treatment, the patient usually presents the clinical form of psoriasis they were suffering previously.
  • Erythrodermic psoriasis. This involves the appearance of generalised erythema that affects more than 90% of the body’s surface area and which may be accompanied by severe systemic symptoms (fever, leukocytosis, elevated acute phase reactants, protein deficit, etc.). It may appear after the withdrawal of oral corticosteroids, as a response to serious sunburn, or due to the use of certain drugs that worsen psoriasis.

Chronic complications

high sugar levels

Cardiovascular risk factors. Psoriasis sufferers have higher percentages of diseases such as diabetes, obesity, and hypertension. It is not yet known whether there is a genetic link between these diseases. This association implies increased mortality in patients with psoriasis. In fact, they are said to be more likely to have what is known as metabolic syndrome, an association of several metabolic disorders such as increased blood sugar, triglycerides, blood pressure levels, and abdominal fat, with decreased HDL cholesterol. The presence of three or more of these metabolic alterations carries an increased risk of cardiovascular disease.

enfermedad inflamatoria, manos con artritis

Autoimmune diseases. In addition, psoriasis is associated with other immunological diseases, particularly rheumatoid arthritis, but also alopecia areata, coeliac disease, and lupus erythematosus.

Man with cloud over, depression

Depression. Depression is twice as common in people with psoriasis as in the general population. The factors contributing to the development of depression in patients with psoriasis include those relating to difficulties with social relationships and factors deriving from the frustration with treatments.

Piernas con varices muy pequeñas, Telangiectasias, arañas vasculares

Complications from topical and systemic treatments. Prolonged use of topical corticosteroids can cause atrophy, stretch marks, or telangiectasia (spider veins). Immunosuppressive drugs may be related to increased infections, although this potential complication can be reduced through better selection.

Substantiated information by:

Felipe Julio Ramirez Garcia
Mercè Alsina Gibert
Paula Aguilera Peiro
Sara Gómez Armayones

Published: 22 February 2019
Updated: 22 February 2019

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