Will My Heart Go On Even If I Have Psoriasis?

The title of this entry must have made you think about the worldwide hit song of Celine Dion "My Heart Will Go On" from the movie Titanic. This post is neither about the movie nor the song. It has something to do with the link between psoriasis and heart disease. Is that news to you?

A number of studies in the last decade have already shown that psoriasis patients are also found to have or to develop cardiovascular diseases, such as high blood pressure or hypertension, high blood cholesterol level, heart failure, atherosclerosis and diastolic dysfunction. One of the theories postulated is that heart disease like atherosclerosis and psoriasis are both inflammatory conditions. The degree of inflammation in skins with psoriasis can be on a titanic scale, as in severe cases which cover the whole body of the patient.

In a 2005 study at Karolinska Institute in Sweden, it was shown that the risk of dying of heart disease for people in the 40-59 age group is 91 percent higher for those with severe psoriasis. For people over 60 with severe psoriasis, the risk is 37 percent greater. Those with mild to moderate psoriasis cases like me should not be complacent because the chance of developing any of the cardiovascular diseases is still there.

Researchers recommend that psoriasis patients must adopt a healthy lifestyle, including a healthy diet. The probability of developing cardiovascular disease is substantially minimized when a psoriasis patient practices healthy living.

On the personal note, I remember in early to middle 2008 when I noticed that something was no longer right with my body although my psoriasis at the time was still manageable. During the first half of that year, I put on an additional 20 pounds to my weight at end-2007. I thought that maybe the reason for my weight gain was due to hypothyroidism which can also be seen in some psoriasis patients. And so I went to see a doctor specializing in internal medicine.

After undergoing a series of blood testing, it was found out that I only had the so-called subclinical hypothyroidism. There were other conditions that were diagnosed, however. These were cardiovascular-related diseases — high blood pressure (which soared as high as 140/100 at some point) and also high blood cholesterol level. I vowed to correct these risk factors — and finally got rid of them in a matter of 90 days after the diagnosis. I was also able to shed 40 pounds. From that time up to now, I have maintained my ideal weight. I still want my heart to go on and function well despite my psoriasis.

Photo credit: Mykl Roventine(flickr.com)

Suffering from Sore Throat? Guttate Psoriasis May Be Erupting Soon

If you have been suffering from sore throat recently, then watch out for any signs of psoriasis flare-ups in the next few weeks. Almost 80 percent of guttate psoriasis onset is triggered by streptococcal (or strep) bacteria, which causes sore throats.

Guttate Psoriasis' Clinical Apperance
In its clinical manifestation, guttate psoriasis may make you look like you had red polka dots of varying sizes all over your body. The Latin word, gutta, means ‘drop,’ hence, the description of droplike, or raindrop-like papules can often be found in books.

If you are more familiar with plaque psoriasis, you would most likely not recognize this condition as psoriasis from a distance. The red-colored spots may be mistaken for chicken pox, because the diameter of the lesions usually ranges between 0.1 and 1.0 centimeter. While the identifiable flakes are also present in guttate psoriasis, it is not as scaly as those in plaque psoriasis.

Guttate psoriasis is usually common among children and young adults. It could be the early manifestation of psoriasis or it could signify a looming acute flare-up of a pre-existing psoriatic condition, usually the plaque-type. If you have plaque psoriasis, then it is easier to diagnose guttate psoriasis. However, if it is the first time that this disease manifested, it may not be immediately diagnosed as psoriasis. Other conditions, such as pityriasis rosea and secondary syphilis, may be suspected. Family history and lab tests to confirm strep infection will be helpful in early diagnosis of guttate psoriasis.

Association of Strep Infection with Psoriasis
The immune system becomes overactive when there is streptococcal throat infection. It was in 1916 when Winfield made an observation that streptococcal infection is associated with psoriasis. The infection activates T-cells at various spots in the skin. These T-cells, which can penetrate into the skin, may mistakenly recognize certain foreign substances in the skin as part of the infection and proceed to attack them.

Some carbohydrates or keratins possess chemical identifiers similar to bacterial antigens. In a sense, the body is confused and over-reacts, believing the strep invasion is bigger than it actually is. As a result, some patients go on to develop the chronic condition of plaque psoriasis.

Guttate Psoriasis Treatment
In most cases, guttate psoriasis is resolved if the underlying infection is treated. It may take a few weeks, or months, for guttate psoriasis to be completely gone. In some patients, the condition does not recur. But in others, it temporarily worsens a preexisting psoriasis (which eventually recedes to its previous state) or it opens the possibility of minor recurrences of psoriasis.

To address strep infection, doctors often recommend a 10- to 14-day antibiotic therapy. Natural sunlight or ultraviolet B therapy may also be prescribed if there is no improvement after a month since the outbreak of guttate psoriasis, or if you have preexisting plaque psoriasis. If the doctor does not prescribe antibiotics, you may want to make sure it is not needed — since you do have the strep infection — or ask for a second opinion.

Photo credit: Foxtongue (flickr.com)

Resources:

Bergstrom, K. and Kimball, A. (2005). 100 Questions & Answers about Psoriasis. (Sudbury, MA: Jones and Bartlett Publishers).

Bos, J. (2004). Skin Immune System, Third Ed. (Boca Raton: CRC Press).

Camisa, C. (2004). Handbook of Psoriasis, Second Ed. (Malden: Blackwell Publishing).