Little attention is paid to the complications of psoriasis, even to the secondary reactions of treatments.
By: Alexander Triana Yanquen
The collective imagination of the population, from their own ignorance about the conditions and complications of pathologies, refers to not paying attention to the signs and signals of the organism, which represents an unimaginable challenge for health professionals. A ‘spot’ in some part of the body can be an indicator of something that can be complicated, bringing with it problems that lead to diabetesalterations cardiovascular and until death.
Exclusively, in the Revista de Medicina y Salud Pública, we spoke with Dr. Mariely Sierra, an endocrinologist and member of the Puerto Rican Society of Endocrinology and Diabetology, about the different complications that the psoriasis. The doctor assures that: “all the systems in the human body go in chain, despite the fact that we think that it is only a cutaneous manifestation. Internally this is an inflammatory cascade, all this cytokine, all these entordoquina, what they are causing is the famous syndrome metabolicwhich means insulin resistance,” he says.
The psoriasis It has a particularity and, being an autoimmune disease, it represents a greater risk of developing diseases such as psoriatic arthritis and diabetes type 2, derived from a “genetic immunological predisposition”. Sierra maintains that “there is a risk of developing diabetes of approximately 4 to 5 percent, on the population that does not have the condition of psoriasis“, Explain.
Educate the patient and the ‘multidisciplinary team’
Ignorance about pathologies and complications that can occur are the daily life of the population worldwide. In this sense, Dr. Sierra assures that: “a multidisciplinary team is really important and education is very important from the beginning of the diagnosis. It is very important not to forget that apart from the fact that we are treating his skin conditions, we have to send him to a multidisciplinary team, such as nutrition, exercise, a trainer, it could be the endocrinologist if he is already developing cardiometabolic manifestations,” Sierra said.
Studies on the psoriasis have managed to determine that this condition, over a long period of time, can also lead the patient to develop cardiometabolic complications: “these patients are more at risk than would be myocardial infarction, cardiovascular disease, fatty liver disease and obviously peripheral vascular disease”, Sierra assures.
The endocrinologist adds that “unfortunately all these cardiometabolic side effects are forgotten in what is the same psoriasis”, comments.
“I have in my clinic a high percentage of diabetic patients with psoriasisand I ask them: did you know that your condition psoriasis could predispose you to diabetes?, and they tell me, no. There we are… perhaps failing from the beginning, or the studies are also often in their infancy”, says the galena.
Many people with a predisposition to psoriasis they may not have symptoms for years until the disease is activated by some environmental factor, genetics, or as a reaction to another type of medical treatment.
Treatments and Side Effects
Dr. Sierra is emphatic in stating that some of the treatments or medications used in the management of psoriasiscan generate insulin resistance, which is vital for patients with diabetes. This is a side effect of the treatment.
For this reason, the work of this multidisciplinary team is essential in the patient’s process. The tests, therapies and assigned treatment are the greatest benefit because “from the beginning of the diagnosis, these patients are going to have a better quality of life,” she says.
Now, Dr. Sierra establishes that the focus on pathologies cannot be lost and follow-up is essential because: “this syndrome metabolic it is progressive and insulin resistance remains. Yes, we can lower inflammation, but lifestyle is paramount,” he says.
He maintains that it is necessary for the patient to be aware of his condition in order for him to make changes in his habits: “his diet, exercise, we are going to reduce carbohydrates, we are going to send him to the nutritionist… You know what to avoid because you have a predisposition to diabetes”, he concludes.
Psoriasis and complications
It is important to recognize what is psoriasis, which is known as an inflammatory skin condition that causes a rash with red, scaly, itchy patches, especially on the knees, elbows, trunk, and scalp. This pathology is frequent and of long duration (chronic) that currently has no cure. In addition, it usually occurs in cycles, with outbreaks that last a few weeks or months and then subside. Now, this disease can evolve if not treated in time and develop diseases such as: psoriatic arthritis, temporary changes in skin color (hyperpigmentation or hypopigmentation after inflammation) in the places where the plaques had healed, conjunctivitis, blepharitis and uveitis; diabetes type 2, arterial hypertension, cardiovascular disease; other autoimmune diseases, such as celiac disease, sclerosis, and the inflammatory bowel disease known as Crohn’s disease, and can also affect mental health.