Psoriasis - Prognosis

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Emotional and Social Consequences

Effect on Quality of Life. The emotional and social consequences of psoriasis should not be underestimated.

• Many patients suffer severe humiliation and depression if plaques are visible. Some even withdraw from society and become isolated.
• Some patients are forced to leave their jobs and go on disability if the condition becomes incapacitating.

Researchers have reported the following:

• Surveys of patients with psoriasis report a negative mental and physical impact that is nearly equivalent to that of other major chronic conditions, including cancer, high blood pressure, diabetes, heart disease, and depression.
• In one study, 75% of patients reported that psoriasis hurt their confidence
• Another study reported that 8% of people with psoriasis felt their life was not worth living.

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Higher Risk for Substance Abuse. Some patients, particularly men, use alcohol and smoking as self-medication to reduce the emotional consequences of psoriasis. In fact, studies have found that people with psoriasis have higher mortality rates, mostly from heavy drinking. Smoking has also been cited as a major risk, particularly for pustular psoriasis. Some experts believe that drinking and smoking may actually cause biological damage that contributes to psoriasis itself.

Physical and Medical Complications of Psoriasis

Folate Deficiency in Severe Psoriasis. Severe psoriasis can also cause folate deficiency. Folate is a B vitamin that is important for nerve function, preventing birth defects. It also prevents elevations of homocysteine, a factor that may play a critical role in heart disease.

Skin Cancers. In one study, patients with severe psoriasis (who receive medications that affect the whole body) were at higher than normal risk for developing cancers, primarily skin cancers and lymphomas. The risk was not any higher for patients with milder psoriasis. There is some indication, however, that patients with psoriasis have a higher risk for non-melanoma skin cancers regardless of treatments.