Psoriasis is associated with significant physical, social, and behavioral comorbidities that create a substantial burden. We outline herein that these comorbidities start early in life and persist for decades, ultimately impacting the entire life course of patients with psoriasis. By highlighting the ages that psoriasis patients are affected with physical, social, behavioral and emotional comorbidities, we demonstrate the age-appropriate considerations for psoriasis patients.
Key points
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People with psoriasis suffer from multiple medical and psychological comorbidities.
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Many of the comorbidities affect patients with psoriasis at a younger age than they do the general population and can persist throughout the lives of these individuals.
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Dermatologists should be able to identify these comorbidities and facilitate intervention when appropriate.
Introduction
Psoriasis is a chronic, systemic, inflammatory disease affecting about 1% to 3% of the population worldwide. Although psoriasis may occur at any age, the peak periods of onset are 16 to 22 and 50 to 60 years of age, with majority of patients developing the disease before age 40. Psoriasis primarily affects the elbows, knees, scalp, genitals, and trunk, but can involve any body location.
In addition to cutaneous manifestations, psoriasis is associated with significant physical and behavioral comorbidities. Moreover, the visibility of the skin lesions creates a strong psychological burden involving relationships, work, social activities and overall well-being ( Table 1 ). It is known that psoriasis has a serious impact on health-related quality of life (HRQL) and it has been proposed that the various physical, social, and psychological impairments may have a cumulative impact on a patient’s life course. Persons with psoriasis have a greater prevalence of comorbidities across all age groups when compared with those without. We emphasize here that some comorbidities start early in life and have implications throughout the following stages of life ( Figs. 1 and 2 ). Ultimately, some comorbidities are difficult to reverse and may have serious health consequences, even if the skin disease is well-controlled. Herein, we highlight the relevant age groups most affected or affected differently than the general population.
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