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Psoriasis-Severity of skin condition linked to diabetes, new study finds

Do you know that people with psoriasis are at a higher risk to develop type 2 diabetes than those without psoriasis? This was the finding of a new study by researchers from the Perelman School of Medicine at the University of Pennsylvania. According to the researchers, the risk of diabetes  increases dramatically based on the severity of the disease too.  They observed that people with psoriasis that covers 10 percent of their body or more are 64 percent more likely to develop diabetes than those without psoriasis. This means that about 125,640 new cases of diabetes may be related to psoriasis worldwide.

“We know psoriasis is linked to higher rates of diabetes, but this is the first study to specifically examine how the severity of the disease affects a patient’s risk,” said the study’s lead author Marilyn T. Wan, a post-doctoral research fellow. The researchers looked at data on 8,124 adults with psoriasis and 76,599 adults without psoriasis over the course of four years to arrive at this conclusion.

The study was published in the November, 2017  Journal of the American Academy of Dermatology.

More information about Psoriasis

What is psoriasis?

Psoriasis is a chronic skin condition that occurs when the body’s defenders become hyperactive, leading to swelling and rapid turnover of skin cells. In psoriasis, new skin cells are produced prematurely (within 3-4 days instead of 30 days) leading to accumulation at the surface. This appears as skin lesions that are red, scaly and itchy. The skin lesions show up on the scalp, hands and feet, genitals and skin folds.

How common is the skin condition?

According to some sources, it affects up to 125 million persons worldwide. In the United States alone, up to 8 million persons suffer from this condition. Although, the skin condition is less common in dark skinned individuals, there have been reports that the occurrence is increasing. In Nigerian study  of patients attending a skin clinic, Psoriasis was found in one out of 100 patients. It was slightly commoner in men, those in there 40’s and triggered by stress, alcohol, and medications.

Why is it linked to diabetes?

“The type of inflammation seen in psoriasis is known to promote insulin resistance, and psoriasis and diabetes share similar genetic mutations suggesting a biological basis for the connection between the two conditions we found in our study,” said the study’s senior author Joel M. Gelfand, MD MSCE, a professor of Dermatology and Epidemiology at Penn.

What you should know about severity of psoriasis?

Psoriasis may be classified  as mild, moderate, or severe according to the amount of body surface area (BSA) affected and the severity of redness, thickness, and scaling of the skin.


Mild (<3%)                     Moderate (3-10%)            Severe (>10%)

Related: Here’s why Psoriasis is difficult to treat

In order to measure psoriasis severity, Gelfand and his team used body surface area (BSA), which measures the percentage of the body covered by psoriasis.
They found patients with a BSA of two percent or less had a relative risk of 1.21 for developing diabetes, meaning their risk is 21 percent higher than those without psoriasis. This risk increased dramatically in patients with a BSA of 10 percent or more. On average, 5.97 out of every 1,000 people will get diabetes in a given year. In the population of patients with a BSA greater than 10 percent, that number jumps to 12.22 per 1,000 people. That group had a relative risk of 1.64, or 64 percent higher than patients with no psoriasis at all. Further, they found that for every 10 percent increase in BSA beyond the initial 10 percent, the relative risk increased by another 20 percent. In other words, patients with 20 percent BSA were at almost an 84 percent higher risk of developing type 2 diabetes, patients with 30 percent BSA were at a 104 percent higher risk, and so on.”These findings are independent of traditional risk factors for diabetes and still show a strong connection between the increasing severity of psoriasis and the increasing risk of developing diabetes, which makes a strong argument for a causal relationship between the two,” Gelfand said.

Gelfand says psoriasis BSA should be routinely measured, and patients targeted for diabetes prevention, especially in those with a BSA of 10 percent or higher. He also says these results add to the growing understanding of the additional risks associated with severe psoriasis, which Gelfand’s other studies have shown can include major cardiovascular events, liver disease and death.



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