This content originally appeared on diaTribe. Republished with permission.

By Alexandra Frost

Diabetes increases the likelihood of psoriasis, a condition that causes patches of itchy, dry skin, but there are treatments available.

As with so many frustrating things about life with diabetes, some conditions increase the likelihood of diabetes, while diabetes increases the likelihood of others. Psoriasis, a skin condition, is certainly one of them.

Each of those conditions are risk aspects for the opposite, which implies individuals with diabetes are more likely than the final population to develop psoriasis. The excellent news is that, in keeping with experts, psoriasis is a typical and manageable condition.

What’s psoriasis?

Sometimes confused with eczema, psoriasis is definitely an autoimmune disease, meaning it results from an abnormal immune system response. The immune system is a fancy network of organs, cells, and proteins that defend against infections from bacteria and viruses while protecting the body’s own cells.

Individuals with psoriasis might experience scales or what are called raised plaques on their skin, which might look different based on various skin types. The elbows, knees, and scalp are common locations where psoriasis plaques crop up.

“Individuals with diabetes are at increased risk for a lot of skin conditions, not only psoriasis,” said Dr. John Browning, a board-certified pediatrician, dermatologist, and pediatric dermatologist based in Texas. “It is a component of the metabolic syndrome (obesity, hypertension, dyslipidemia, and insulin resistance).”

Browning said the condition is commonest in individuals with type 2 diabetes. Although psoriasis is commonly seen in adults with diabetes, he’s seeing a surge within the skin condition in children with type 2 diabetes, pointing to the obesity epidemic because the cause.

While psoriasis may not sound too serious, the skin condition can result in further complications, said Dr. Lindsey Bordone, assistant professor of dermatology at Columbia University.

“For individuals with diabetes who experience itchy skin where they’ve psoriasis plaques, easy breaks within the skin from scratching can result in an increased risk for infection as a result of bacteria introduced from under the nails,” Bordone said.

As well as, high blood glucose and insulin levels can each affect psoriasis. Insulin, for instance, has been shown to have a direct inflammatory effect, Bordone said.

Why is psoriasis more common in individuals with diabetes?

Like so many other diabetes complications, the impact of high insulin levels as a result of insulin resistance is a significant factor. One 2021 study concluded that insulin resistance could be the underlying link between diabetes and psoriasis.

There’s also a relationship between weight gain, inflammation, and skin health for people living with diabetes.

“The severity of psoriasis increases with body mass index. Type 2 diabetes also increases with body mass index,” said Bordone. “Since exercise could be uncomfortable for those with moderate to severe psoriasis, this results in further weight gain and places patients at an increased risk of type 2 diabetes or exacerbates their diabetes if already present.”

What psoriasis treatments can be found for individuals with diabetes?

Like most skin conditions, attending to the basis cause is vital in treating psoriasis, reasonably than responding to the symptoms alone.

Browning said some immunosuppressive agents, reminiscent of methotrexate or cyclosporine, could be difficult for individuals with diabetes to make use of as they’re already at high risk for liver and kidney disease.

“Newer medications are safer and more practical for individuals with diabetes,” he said. He also pointed to treatment plans that mix skin, diabetes, and body weight interventions together.

“As more medications grow to be available that decrease insulin resistance and reduce body weight, we’ll see fewer complications of diabetes on the skin,” Browning said. “It’s vital to manage psoriasis with effective therapies in order that patients can exercise and avoid being withdrawn. Most of the latest medicines also help reduce the danger of psoriatic arthritis.”

One other autoimmune disease, psoriatic arthritis is a kind of inflammatory arthritis (individuals with psoriasis can develop it, but it may occur in anyone). Finding the proper treatment for psoriasis if you could have diabetes generally is a difficult technique of trial and error, and as experts like Bordone mentioned, drug selection could be a problem.

Nevertheless, the longer term is vibrant for treating psoriasis. There’s a giant push to enhance metabolic conditions like extra weight and high blood sugar in patients with psoriasis, Bordone said.

“The newer class of GLP-1 medications have made a big effect in health outcomes for psoriasis patients in each controlling their diabetes and improving their psoriasis as a result of weight reduction,” she said. Examples of effective GLP-1s include Ozempic and Mounjaro.

Experts also point to exercise as a significant profit for people living with psoriasis and diabetes. Walking every day or engaging in other forms of normal exercise is critical for health, Browning added.

Why a team effort is simplest for treatment

Anyone living with diabetes knows that a team of doctors is commonly involved. On this case, which may include a dermatologist, endocrinologist, primary care physician, and others.

Bordone said she works closely with patients’ endocrinologists to resolve psoriasis and optimize outcomes. Browning added that this collaboration could be key to identifying less obvious skin conditions like necrobiosis lipoidica or granuloma annulare.

“All of us work together to stop complications from diabetes on the skin, heart, joints, kidneys, and liver,” said Browning. “Often a dermatologist may also help diagnose a rare condition that’s related to diabetes, which can even help establish a diabetes diagnosis.”

Though psoriasis can feel complicated and uncomfortable, experts like Browning encourage patients to succeed in out to their medical team early to start with a treatment plan that works for them.

Learn more about skin health and diabetes here: