The more surface area of the body covered by psoriasis, the greater the risk of death, according to a new analysis by researchers at the Perelman School of Medicine at the University of Pennsylvania.

In fact, patients with psoriasis on 10 percent or more of their body are at almost double the risk of death, the study found.

The findings, which appear in in theJournal of Investigative Dermatology, are the first to link psoriasis severity to an increased risk of death using an objective measure of disease severity – called Body Surface Area (BSA) – rather than treatment patterns, such as whether or not a patient was receiving oral, injectable or phototherapy treatment for the condition.

For this study, Joel M. Gelfand, MD, MSCE, a professor of Dermatology and Epidemiology at Penn and his team looked at 8,760 patients with psoriasis and 87,600 people without it via a database from the United Kingdom.  They sent surveys to the patient’s general practitioners to determine the body surface area affected by psoriasis as this information is not routinely available in medical records. They then looked at the number of deaths in each group by person-years.

Gelfand and his team used an average follow-up time of about four years. In that time, there was an average of 6.39 deaths per 1,000 person years in patients with psoriasis on more than 10 percent of their bodies, compared to 3.24 deaths in patients without psoriasis. Even when researchers adjusted for other demographic factors, patients with a BSA greater than 10 percent were 1.79 times more likely to have died – almost double – than other people their age and gender who do not have the condition. This risk held even after researchers controlled for other risk factors like smoking, obesity, and major medical conditions.

The researchers say more research is needed to better understand the specific causes of death in patients with extensive psoriasis and to see if and how treatment can impact the risk.

The study was supported by a medical dermatology fellowship from the National Psoriasis Foundation and the National Institutes for Health (T32-GM075766, K24-AR064310-36).          

PHOTO CREDIT: Penn Medicine


PHOTO CAPTION: An example of severe psoriasis