Psoriatic Arthritis Complications

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Psoriatic arthritis is primarily characterized by musculoskeletal manifestations and skin manifestations of the disease. People with psoriatic arthritis also have a higher risk of developing other chronic conditions which may be serious. Such conditions are referred to as comorbidities. An awareness of potential complications and comorbidities is important. You must pay attention to signs and symptoms and notify your doctor when they develop.

Cancer

People with psoriatic arthritis have an increased risk of certain cancers. The higher risk of cancer has been associated with the disease itself and not with any specific treatment. A study published in the Journal of Clinical Rheumatology found that the rates of solid and non-melanoma skin cancers were similar between people with psoriatic arthritis and those without psoriatic arthritis. However, the rates of hematologic cancer, as well as opportunistic infections, were higher in psoriatic arthritis patients. Because of the higher risk, people with psoriatic arthritis should be committed to having routine cancer screenings.

Cardiovascular Disease

Psoriatic arthritis and psoriasis patients have a higher risk for developing cardiovascular disease. A significant proportion of patients with psoriatic arthritis have a cardiovascular event at some point during the course of their disease. The increased risk is related to traditional cardiovascular risk factors and psoriatic arthritis disease activity.

Depression

Patients with psoriatic arthritis have an increased risk of developing depression or mood disorders. Researchers investigated the connection and found that, after comparing a group of study participants with psoriatic arthritis to a group without psoriatic arthritis, there was a higher rate of depression in those with psoriatic arthritis. The rate of suicidal behaviors was similar between the two groups. 

Diabetes

People with psoriatic arthritis have an increased risk of developing type 2 diabetes. There appears to be a correlation between the severity and duration of psoriasis and the risk of developing type 2 diabetes.

Inflammatory Bowel Disease

There is a link between psoriasis, psoriatic arthritis, and inflammatory bowel disease. A study that assessed extra-articular manifestations of psoriatic arthritis (i.e., other than joint involvement) found that 33% of study participants had symptoms of bowel involvement. It has been suggested that patients with psoriatic arthritis and Crohn's disease share similar genetic risk factors.

Metabolic Syndrome

Metabolic syndrome refers to a group of conditions—heart disease, obesity, and high blood pressure. There is a significant connection between psoriatic arthritis and metabolic syndrome. About 40% of people with psoriasis have metabolic syndrome compared to 23% of the general population. About 44% of people with severe psoriatic arthritis are at risk for metabolic syndrome.

Non-alcoholic Fatty Liver Disease

People with psoriasis and psoriatic arthritis may be at greater risk for developing a liver condition, known as non-alcoholic fatty liver disease. Patients with non-alcoholic fatty liver disease and psoriasis tend to have more severe skin disease. They also have a higher risk of severe liver fibrosis compared to people without psoriasis.

Obesity

There is a known connection between psoriatic disease and obesity. Study results suggest that obesity by 18 years of age increases the risk of developing psoriatic arthritis. Adiposity, or excessive fat, is linked to higher levels of inflammatory cytokines that are associated with psoriasis. Prevention of obesity or losing weight may decrease the risk of developing psoriatic arthritis.

Osteoporosis

There appears to be a connection between osteoporosis and psoriatic arthritis. There is a distinct relationship between chronic inflammation, cardiovascular risk factors, and bone loss in psoriatic arthritis.  Patients with psoriatic arthritis appear to have microstructural deficits of bone which make them susceptible to bone fragility and fracture.

Uveitis

Psoriasis and psoriatic arthritis increase the risk of developing uveitis, an inflammatory eye condition. Approximately 7% of people with psoriatic arthritis develop uveitis.

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