Did you know that as many as one third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives? I find this to be a little talked about area of diabetes. We all know to take care of our feet and infections, but no one ever told me about the connection between skin conditions and diabetes.
I have psoriasis. I was also diagnosed a couple years ago with psoriatic arthritis. It's no fun to be diagnosed with arthritis while still in your twenties. My joints become inflamed and sometimes I feel like an old lady. My boyfriend has to open the ibuprofen bottle or twist the cap off my bottle of soda. That kind of thing. End of the world? Of course not. Embarrassing? A bit.
Like diabetes, I have found living with the lifelong condition of psoriasis and now psoriatic arthritis is physically and emotionally challenging. Several studies have shown that people often feel frustrated and that stress, anxiety, loneliness, and low self-esteem are part of daily life for people living with psoriasis. One study found that thoughts of suicide are three times higher for psoriatics than the general population.
Of course being diagnosed with type 1 diabetes as a little girl was a lot more serious, but in some ways maybe not as tough initially. I mean kids are adaptable and often go with the flow better than us grown-folk and my twin sister already had diabetes so at least we were "even" and I was special, too. Twins need things to be exactly the same--totally fair. I was young enough to make important changes early on. Now? I don't so much like having to switch things up when it comes to my daily routine and habits.
What some of you may not know is that having one auto-immune disease like type 1 significantly increases the odds of being diagnosed later with another (and another) thanks to that wonky auto-immune system. I was diagnosed with psoriasis a year or so after being diagnosed with diabetes. I was in seventh grade. I had red scaly skin on my scalp. I noticed it one day during Mrs. Crandall's Social Studies class. It itched a bit and the skin peeled off when I started to pick at it out of boredom in between taking notes on Chinese history. I was scared and remember thinking it was gross. I was afraid to tell anyone about it, and didn't tell my mom for several weeks. Until this year, I always had a "mild" case of psoriasis, with the affected area being only my hairline, with an occasional patch on my elbows and ears (I know). I can hide it well and most people don't know I have it. Like my diabetes. psoriasis is a condition that is largely unnoticeable upon intial viewing, but affects my life in major ways.
I am self-conscious and it affects my confidence and sense of health. My psoriasis sometimes leaves flakes on my clothes that look like dandruff. I hate that. I wear black a lot and I always worry about it. It is a constant annoyance and affects my self-esteem. Stress and winter weather make it worse. This winter has been awful with inflammations and new spots cropping up. Most recently smack dab in the middle of my forehead and then a big spot on the nape of my neck. A part of my body I actually really like!
Like diabetes, psoriasis is an auto-immune disease. And like diabetes, psoriasis and psoriatic arthritis are chronic, lifelong, conditions with no cure, though people often experience flares and remissions throughout their life. Doctors are unsure what causes it. Genetics seem linked. Controlling the signs and symptoms typically requires lifelong therapy. Psoriasis is not totally understood, but develops when the immune system tells the body to over-react and accelerate the growth of skin cells. Normally, skin cells mature and are shed from the skin's surface every 28 to 30 days. When psoriasis develops, the skin cells mature in 3 to 6 days and move to the skin surface. Instead of being shed, the skin cells pile up, causing the visible lesions. Gross, eh?
Why do I bring this up? Well, researchers have identified genes that cause psoriasis. These genes determine how a person's immune system reacts. These genes can cause psoriasis or another immune-mediated condition such as type 1 diabetes. The risk of developing psoriasis or another immune-mediated condition, especially diabetes or Crohn's disease, increases when a close blood relative has psoriasis (as my grandfather did). That said, like diabetes, some people who have a family history never develop this condition. Research indicates that a "trigger" is needed. For both diabetes and psoriasis, I believe mine was my father's remarriage, my mom's relapse and pending remarriage, and the pain that is middle school. Stress overload for an eleven year old.
Embarrassment is another common feeling. I once met a woman with psoriasis who felt such shame over her condition that she rarely left the house. When I took her hand, she cried, as she relayed a story about a check-out lady who refused to touch her hand when giving her change. It broke my heart. Like diabetes, psoriasis is not contagious. It's important to bring this issue to light and lessen some of the stigma. For those of you here on DiabetesCentral, please leave a comment, if possible.
Do any of you have skin conditions? I'm not talking about mild acne (who hasn't experienced that?) or the occasional break-out. If so, does your skin condition affect your daily life in big or little ways? Did your condition develop around the time of your diabetes diagnosis or during a stressful time in your life and/or a time when your immune system was compromised?
Thanks to those of you who will hare your stories below...
Published On: April 07, 2010