Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.
When you have an autoimmune disease, like psoriasis, your immune system goes a bit haywire and mistakenly attacks healthy cells4, often setting off mysterious symptoms before you get to the bottom of it. There are more than 80 autoimmune conditions that impact different parts of the body, including everything from multiple sclerosis to arthritis to celiac disease to type 1 diabetes4.
And some of these diseases are more likely to affect people who already have psoriasis. For example, Crohn’s disease and ulcerative colitis, both autoimmune conditions that affect the gastrointestinal tract, are more common in people with psoriasis compared to those without it. However, researchers don’t know why this happens, and with many of these conditions, it is impossible to say which came first or if one caused another.
“There’s no specific answer to the ‘chicken-and-egg’ question,” Shivani Kaushik5, M.D., an assistant professor at the Rutgers Center for Dermatology, tells SELF. One possible theory, according to Dr. Kaushik, is that many autoimmune conditions, including psoriasis, Crohn’s disease, and ulcerative colitis, may be linked because they all cause inflammation in the body. “For many patients who have extensive psoriasis, there is no doubt that they have inflammation going on inside as well,” she says, as opposed to the inflammation you only see on the outside of the skin.
There is no surefire way to avoid developing multiple autoimmune disorders, but keeping your psoriasis in check by regularly taking your medications, such as biologics to target the immune system directly, and getting in touch with your doctor if you have new or worsening flare-ups can help you create a plan to keep inflammation under control.
Psoriatic arthritis (PsA), while technically also an autoimmune condition6, has a more specific connection to psoriasis than other autoimmune diseases. Psoriatic arthritis most commonly shows up 7 to 10 years after the onset of psoriasis symptoms7, and happens when the immune system starts to attack healthy joints and/or tendons causing inflammation, pain, swelling and stiffness in the hands, knees, wrists, ankles and feet.
The two conditions are inextricably linked, but the connection isn’t totally clear to experts yet. Having psoriasis doesn’t necessarily cause psoriatic arthritis. Only about 20 to 30% of people with psoriasis are eventually diagnosed with psoriatic arthritis8 and a small number of people with psoriatic arthritis have no preexisting psoriasis symptoms9.
“We do know certain kinds of psoriasis patients tend to have higher chances of developing psoriatic arthritis,” including scalp psoriasis and inverse psoriasis, according to Samar Gupta11, M.D., an associate professor at the University of Michigan Medical School and the chief of VA clinical rheumatology and medical education.
So, it’s crucial to communicate any joint pain to your doctor if you have psoriasis, since early detection can help you start treatment sooner, which can help prevent psoriatic arthritis-related joint damage.
There’s a lot of research showing that chronic inflammation may cause fat and cholesterol buildup, called plaques, in your arteries12. Over time, and if you have a lot of buildup, plaques can burst and eventually lead to a stroke or heart attack. Reducing overall inflammation is really important when it comes to reducing your heart disease risk, Dr. Menter says, and one way you can do that is by controlling your psoriasis with medication.