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Amy Huang, MD, spoke with Physician’s Weekly about the non-pharmacologic options for managing comorbidities in patients with psoriasis.
At this year’s Fall Clinical Dermatology Conference, numerous presenters discussed the dermatologist’s role in managing psoriasis comorbidities with non-pharmacological strategies.
In a separate resource from the American Academy of Dermatology Association that was not related to the meeting, the organization compiles information about psoriasis triggers and how to avoid flare-ups. Another similar resource from the National Psoriasis Foundation explores diet modifications for managing psoriasis.
“In order to reduce flare ups, it helps if patients can start to think about what it is that causes their trigger,” Alexa Boer Kimball, MD, MPH, said during a video discussion with the AAD.
In some scenarios, the non-pharmacological strategies for avoiding these triggers can also help manage psoriasis comorbidities. In her example, Dr. Kimball suggested that patients who experience flare-ups in the winter use more moisturizer—but there are many other triggers for psoriasis and non-pharmacological strategies to help manage them.
Common Psoriasis Comorbidities & The Dermatologist’s Role
“Metabolic syndrome, or the presence of increased blood pressure, high blood sugar, excess body fat, and abnormal cholesterol levels, as well as heart disease, obesity, hypertension, dyslipidemia, and Type 2 diabetes, are common comorbidities in patients with psoriasis,” Amy Huang, MD, tells Physician’s Weekly (PW). “Other common comorbidities include sleep apnea, depression, and anxiety.”
Although many of these comorbidities are primarily managed by other clinicians, dermatologists play a significant role as well.
“I work together with primary care providers to ensure my patients with psoriasis are getting the care they need for their comorbidities,” Dr. Huang says.
Non-Pharmacological Strategies for Psoriasis Comorbidities
Non-pharmacological strategies are successful for many patients and should be considered first, if medically appropriate, for managing psoriasis comorbidities like hypertension and dyslipidemia.
“Diet, exercise, and stress reduction techniques are some of the ways patients with these comorbidities can manage them,” Dr. Huang says. “Maintaining a healthy diet and becoming more active are paramount.”
The National Psoriasis Foundation encourages a heart-healthy diet for managing psoriasis and heart-related comorbidities like hypertension and dyslipidemia. Their recommendations include two servings of fish rich in omega-3 fatty acids each week—like salmon and trout—as well as lean meats, fat-free and low-fat dairy, and limiting fatty foods. A heart-healthy diet also has less than 1,500 mg of sodium each day.
Regular exercise is another non-pharmacological strategy that can help manage psoriasis comorbidities, both by helping maintain a healthy weight and promoting heart health. Staying active helps condition the heart, lower blood pressure, and encourage healthy cholesterol levels, making it an excellent non-pharmacological strategy for many psoriasis comorbidities.
In addition to these strategies, quitting smoking and avoiding drugs and alcohol may help reduce blood pressure, lower cholesterol, and manage other psoriasis comorbidities.
Pharmacological Treatment Can Fill in the Gaps
If non-pharmacological therapies aren’t effectively managing psoriasis comorbidities, pharmacological options can help fill the gaps.
“Non-pharmacological therapies, alone, are not always entirely effective,” Dr Huang says. “Non-pharmacological therapies are complementary to pharmacological treatments.”
