Treat Psoriasis with Topical Corticosteroids to Reduce the Risk of Metabolic Syndrome

Psoriasis is a chronic autoimmune disease in which the body overproduces skin cells, causing thick, red, dry, scaly patches of inflammation on the skin. Almost 8 million Americans have psoriasis. Psoriasis sufferers with less than 2% of their body affected are considered to have a mild case; those with 3% to 10% of their body affected are considered to have a moderate case, while those with more than 10 percent of their body affected are considered to have a serious case of psoriasis.

For some as-yet-unknown reason, people with psoriasis are at double the risk of metabolic syndrome, a cluster of risk factors for diabetes and heart disease. Metabolic syndrome dramatically increases the risk of type 2 diabetes, heart attack, stroke and peripheral vascular disease (damage to or blockage in the arteries). People with 3 or more of the following are considered to have metabolic syndrome:

•          high blood pressure

•          excessive abdominal fat

•          high fasting blood sugar

•          low HDL (“good”) cholesterol

•          high triglycerides (fatty substances in the blood)

An examination of data from over 6500 Americans compiled in the recent National Health and Nutrition Examination Survey revealed that 40% of the study participants with psoriasis had symptoms of metabolic syndrome, compared to just 23% of people without psoriasis. Excess abdominal fat was the most common symptom (63%), followed by high triglyceride levels (44%) and low HDL cholesterol levels (34%).

"These findings from a nationally representative sample of US adults show a doubling in the prevalence of metabolic syndrome among patients with psoriasis, independent of age, sex, race and C-reactive protein levels (a marker of inflammation)," wrote the study's authors, "Given its associated serious complications, this comorbidity (simultaneous appearance of multiple illnesses) needs to be recognized and taken into account when treating individuals with psoriasis."

The cause and effect between psoriasis, obesity, diabetes and metabolic syndrome remains unclear. There's evidence that obesity fosters the development and hinders the treatment of psoriasis, and there are also connections between inflammation and insulin resistance (a condition in which the body no longer uses insulin properly, setting the stage for diabetes). As well, patients with psoriasis were found to have higher than normal levels of leptin, a hormone involved in body weight and food intake.

The bottom line is that reaching and maintaining a healthy weight is crucial to addressing obesity, diabetes and metabolic syndrome, and helpful in controlling psoriasis. There is no cure for psoriasis, but there are a number of effective psoriasis treatments available, including over the counter and prescription medications:

•         Topical corticosteroids such as Betamethasone

•         Vitamin D Dovonex cream (generic calcipotriene)

•         Topical retinoids like Tazorac cream (generic tazarotene)

•         Oral retinoids (acne medication pills) such as Soriatane (generic acitretin)

•         Ultraviolet light treatment

•         Immunosuppressant drugs such as Rheumatrex (generic methotrexate) and cyclosporin A

•         Immunomodulator drugs (also called biologics)

Your doctor or dermatologist can help you decide which over the counter or prescription medications for psoriasis are best for you.