Psoriasis - Prognosis

Highlights	Diagnosis	Managing Psoriasis
Introduction	Treatment	Resources
Causes	Topical Medications	References
Risk Factors	Other Medications
Prognosis	Phototherapy

Prognosis

Although psoriasis is not fatal, it can increase the risk for drug and alcohol abuse that, in some studies, has increased mortality rates in psoriasis patients. Even in its mildest form, psoriasis can still cause itching, burning, stinging, and bleeding. These symptoms can be very debilitating in more severe cases.

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Severity of psoriasis itself ranges from one or two flaky inflamed patches to widespread pustular psoriasis that, in rare cases, can be life threatening. The skin is usually categorized as mild to severe depending on the extent of the psoriasis to help determine treatment:

Mild psoriasis affects less than 5% of the body surface. Most cases of psoriasis are limited to less than 2% of the skin.
Moderate psoriasis covers 5 - 20% of the skin. (Some experts believe the cut-off should be lowered to 10%, particularly when psoriasis involves hands or feet.)
About 5% of cases fall into the moderate to severe category, which extends beyond 20% of the skin's surface. In general, severe psoriasis affects over 30% of the body. Widespread psoriasis (erythrodermic psoriasis and generalized pustular psoriasis) can be life threatening. Fortunately these occurrences are rare.

Some forms of psoriasis can be very resistant to treatment even though they are not categorized as severe. They include:

Any psoriasis on the palms and soles.
Inverse psoriasis (which occurs in the folds of the skin).
Scalp psoriasis.
Psoriatic arthritis.

Course of Psoriasis

Psoriasis is lifelong and not curable. Although it is also marked by rapid cell growth, psoriasis is neither cancerous nor contagious. In general, studies report the following features of its course:

The condition almost always relapses. In a few cases, large areas of plaque can persist for years.
Psoriasis nearly always goes into remission, however, often clearing spontaneously. In one study, 30% of patients reported untreated psoriasis going into remissions that lasted from one to 54 years.
Psoriasis can improve during pregnancy, especially during the second and third months. Increased levels of estrogen may be responsible for this improvement. Relapse may occur after giving birth.

Emotional and Social Consequences

Effect on Quality of Life. The emotional and social consequences of psoriasis should not be underestimated.

Many patients suffer severe humiliation and depression if plaques are visible. Some even withdraw from society and become isolated.
Some patients are forced to leave their jobs and go on disability if the condition becomes incapacitating.