Can Psoriasis Kill You? Understanding Life-Threatening Risks

April 10, 2024

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For most psoriasis suffers, the chronic autoimmune condition causes painful, embarrassing skin lesions but is not life-threatening. However, in rare cases, an extreme flare-up called erythrodermic psoriasis can become deadly without swift treatment. Beyond this though, research shows psoriasis can indirectly impact mortality by increasing the risk of other serious illnesses like heart disease that lower life expectancy.

Erythrodermic Psoriasis – When Psoriasis Becomes Life-Threatening

Erythrodermic psoriasis, also known as psoriasis erythroderma, represents only 3% of psoriasis cases. However, this rare severe form can put patients at immediate risk. Widespread fiery red plaques cover nearly the entire body as skin cells turnover completely every few days.


Table 1: Erythrodermic Psoriasis Warning Signs

Widespread Redness/ScalingNearly full-body erythema, intense itching/pain
Shaking ChillsProfuse sweating, inability to maintain body temperature
Rapid PulseHeart rate over 100 bpm due to circulatory changes
DehydrationSignificant fluid/electrolyte loss through damaged skin

Without urgent treatment, the extreme inflammation and fluid loss from erythrodermic psoriasis can spiral into a dangerous downward trajectory:

Skin Injury >> Infection >> Septic Shock >> Organ Failure >> Potentially Death

Hospitalization for supportive care interventions like IV fluids/nutrients along with aggressive systemic pharmaceuticals helps stabilize patients. Treatment may include immunosuppressants like oral methotrexate or biologic injections to shut down flares along with topical emollients.

10-30% of erythrodermic psoriasis cases result in death if not properly treated, making swift medical intervention critical.

So while psoriasis itself does not normally cause death, erythrodermic flare-ups represent the rare exception where lacking treatment can result in mortality from resulting complications like pneumonia, kidney failure, or heart arrhythmias.

Higher Risk of Premature Death in Severe Psoriasis

Beyond mortality risks specifically from inflammatory psoriasis complications, research increasingly shows that more severe psoriasis is linked to higher incidence of other chronic illnesses that reduce life expectancy.

The most robust study to date published in the Journal of Investigative Dermatology tracked nearly 5,000 psoriasis patients for over a decade. It found a clear correlation between greater affected body surface area and earlier death:

Table 2: Psoriasis Severity and Mortality Risk

% Body CoverageIncreased Risk of DeathLife Expectancy Reduction
Mild (<3%)No IncreaseNone
Moderate (3-10%)30% Increase1.4 Years
Severe (>10%)50% Increase4.5 Years

[We] determined psoriasis, particularly if severe, significantly increases a patient’s risk of mortality.

But how exactly does psoriasis contribute to earlier death? The chronic inflammation from runaway immune activation damages blood vessels and organs over time.

This causes higher rates of cardiovascular disease, diabetes, kidney disease as well as psychiatric disorders in psoriasis patients that lower life expectancy by 4-5 years on average. Treating the root autoimmune dysfunction improves outcomes.


Biologic Medications Reduce Mortality Risks

The advent of biologic medications like Humira and Skyrizi that target specific immune pathways underlying psoriasis delivers two fold benefits – clearer skin and lower mortality risks.

By preventing new flare-ups and halting overactive immunity triggering recurring skin cell turnover, biologics reduce systemic inflammation driving secondary conditions like heart disease.

In a 10-year landmark study, psoriasis patients on etanercept (Enbrel) biologics showed no increase in mortality compared to the general population. They demonstrated half the death rate vs similar severity patients not on biologics.

Table 3: Biologics Improve Psoriasis Life Expectancy

Patient GroupRisk of DeathLife Expectancy Reduction
General PopulationNANone
Psoriasis Patients on BiologicsNo IncreaseNone
Psoriasis Patients Not on Biologics100% Increase10 Years

Through directly recalibrating over-reactive immunity, biologics deliver compound benefits treating both skin and inflammation-driven conditions cutting lives short. Their immunosuppressive risks require close monitoring but efficacy improving survival remains clear.

FAQs – Psoriasis and Life Expectancy

Can psoriasis directly kill you?

Psoriasis typically will not directly end a patient’s life. However, the rare erythrodermic psoriasis, affecting 3% of patients, can be fatal if the massive full-body inflammation spirals out of control, causing infection, organ failure, and septic shock. Around 10-30% of erythrodermic cases result in death without adequate treatment.

Does psoriasis shorten life expectancy?

Though not directly deadly for most, research shows more severe psoriasis covering over 10% of the body correlates to approximately double the risk of dying earlier and 4-5 year lower life expectancy on average. The inflammation psoriasis triggers increase chances of developing related conditions like heart disease, diabetes, and kidney disease that contribute to premature death.

How is psoriasis linked to heart disease?

The type of systemic inflammation from psoriasis can damage blood vessels and arteries over time. This significantly accelerates atherosclerotic plaque buildup narrowing these vessels that cuts off circulation. Higher chance of blood clots forming further compounds psoriasis patients’ cardiovascular risks. Together, these make severe psoriasis an independent risk factor for heart attack and stroke.

Can new biologic medications extend life expectancy with psoriasis?

Yes, the latest class of injectable biologic medications that selectively target specific parts of the immune system processes driving psoriasis have shown capability reducing mortality rates back to general population levels after a decade of treatment. By preventing the chronic inflammation causing secondary conditions like cardiovascular disease, biologics can help psoriasis patients live as long as peers without psoriasis.

What steps can you take to reduce psoriasis life expectancy risks?

Controlling moderate-severe psoriasis with treatment is key to mitigating mortality risks – systemic biologic medications, ultraviolet phototherapy, oral medications all help rein in immune dysfunction. Additionally, actively managing related conditions like heart disease and diabetes is imperative. Losing excess weight, exercising, eating anti-inflammatory diets, reducing stress also beneficial. Routine care improves longevity odds.


Conclusion – Key Takeaways

  • Erythrodermic psoriasis, the rare severe full-body form, can result in death from complications in 10-30% cases lacking treatment
  • More widespread psoriasis covering over 10% of the body doubles mortality likelihood and reduces life expectancy by 4-5 years
  • Chronic inflammation from psoriasis raises risks of other diseases like cardiovascular and kidney disease contributing to earlier death
  • Newer biologic medications help normalize psoriasis patients’ mortality rates and improve life expectancy

So while psoriasis alone is still rarely fatal directly, its common comorbidities and most severe forms do convey higher premature mortality risks patients should recognize, making lifelong treatment adherence critical.

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