Psoriasis: More Than Skin Deep

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The skin lesions of psoriasis are bad enough. Dr. Kristine E. Nograles and coauthors at The Rockefeller University in New York described the cellular changes in four steps: thickened epidermis from accelerated growth of skin cells, reduced granular layer caused by failure of cells to differentiate properly, redness from blood vessel dilation, and high numbers of cells associated with inflammation. “Psoriasis is a complex genetic disorder,” they explained, “which means that it is a multi-factorial heritable disease that is influenced by multiple genes and environmental factors.” It has been known for some time that family history is a risk factor for psoriasis. Now that the human genome has been sequenced, several different gene regions are associated with the disease, and three of these involve specific inflammatory pathways.

Mild cases can be treated successfully with skin preparations. More severe cases can be a sign of deeper problems. Dr. Ramin Ghazizadeh of the Academic Dermatology and Skin Care Institute in Chicago, Illinois, and his colleagues in Japan reported that psoriasis and cardiovascular disease share many of the same mechanisms. They wrote, “it is now widely believed that psoriasis is not just a skin disease but a systemic inflammatory process.”

At the cellular level, arteries with atherosclerosis and skin with psoriasis lesions have a lot in common, according to Ghazizadeh. Inflammatory cytokines and infiltrating white blood cells characterize both conditions, which often occur together.

Dr. Aldona Pietrzak and colleagues in Poland reported that lipid metabolism disturbances are responsible for the increased risk of cardiovascular disease, high blood pressure, atherosclerosis, diabetes type 2, obesity, chronic obstructive pulmonary disease, cancer and depression in patients with psoriasis. In the skin, lipids serve important functions as structural components and in protective skin oils. Psoriasis plaques have increased levels of total lipids, phospholipids, triacylglycerols, and cholesterol. These same lipids are increased in the blood of psoriasis patients.

“The lipid disturbances are recognized as a very important part in the pathogenesis of psoriasis,” Pietrzak noted. Thus, treatment should include the following heart-healthy dietary considerations:
1. Reduction of animal fat
2. Inclusion of fish and plant oils high in omega-6 and omega-3 fatty acids
3. Maintenance of healthy weight

References:

1. Nograles KE et al, “New insights in the immunologic basis of psoriasis”, Seminars in Cutaneous Medicine and Surgery 2010 March; 29(1): 3-9. http://www.ncbi.nlm.nih.gov/pubmed/20430301

2. Pietrzak A et al, “Lipid disturbances in psoriasis: An update”, Mediators of Inflammation 2010; pii 535612. http://www.ncbi.nlm.nih.gov/pubmed/20706605

3. Ghazizadeh R et al, “Pathogenic mechanisms shared between psoriasis and cardiovascular disease”, International Journal of Medical Sciences 2010; 7(5): 284-89. http://www.ncbi.nlm.nih.gov/pubmed/20827428.

Reviewed June 9, 2011
Edited by Alison Stanton

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.