Psoriasis is a chronic, autoimmune, inflammatory condition that primarily affects the skin. Because the condition is caused by an overactive immune system, the treatment involves using medications to calm the immune system (immunomodulatory effect).
With the ongoing COVID-19 pandemic, researchers and health experts are concerned whether psoriasis and the immunomodulatory medications, such as steroids and biologic agents used for psoriasis treatment, will increase the risk of COVID-19.
- It is not known with certainty whether psoriasis or psoriatic arthritis worsens the prognosis of COVID-19.
- Data available so far indicates that people with psoriasis and psoriatic arthritis have similar rates of SARS-CoV-2 infection and COVID-19 outcomes as the general population.
- Furthermore, the data suggests none of the treatments administered for psoriasis significantly affect the risk of acquiring SARS-CoV-2 infection or having worse COVID-19 outcomes.
Psoriasis treatment (such as systemic steroids), however, could be modified during active SARS-CoV-2 infection based on the treating healthcare team’s decision made after a discussion with the patient.
Nonetheless, people with psoriasis and psoriatic arthritis have a higher likelihood of certain underlying conditions (comorbidities) that can lead to a poorer COVID-19 outcome. These conditions include obesity, diabetes, heart diseases, lung conditions, and kidney diseases.
What are the symptoms of COVID-19 with psoriasis?
The symptoms of COVID-19 in psoriasis patients are similar to other people without psoriasis. COVID-19 symptoms may take 2 to 14 days to appear after exposure to infection.
Some patients may not have any obvious signs or symptoms (asymptomatic). When present, the symptoms may include:
- Runny or stuffy nose
- Sore throat
- Changes in taste or smell
- Shortness of breath or trouble breathing
- Reduced appetite
- Nausea, vomiting
- Abdominal pain
Some patients may experience certain signs and symptoms of severe COVID-19. They must report to the doctor immediately if they observe any of the following:
What should patients with psoriasis do to protect themselves from getting COVID-19?
Vaccines against COVID-19 are a proven, safe, and effective way to prevent the disease, including severe manifestations of COVID-19.
- People with psoriasis and psoriatic arthritis must get vaccinated against COVID-19, including boosters, if they are eligible.
- Psoriasis and psoriatic arthritis or their medications are not a contraindication to the mRNA-based COVID-19 vaccine.
- They must take their annual flu shots that could be timed in consultation with their provider.
Patients with psoriasis must follow other COVID-19 safety precautions, such as avoiding crowded places, following proper hand hygiene and respiratory hygiene, and wearing a face mask wherever necessary.
If frequent hand washing or alcohol-based sanitizers are making the skin lesions worse, ask the provider about milder, hypoallergenic, hydrating, cleaning agents. Rinse well to remove all soap residue and moisturize the skin well.
What is the treatment for COVID-19?
If a person tests positive for the SARS-CoV-2 virus, they must tell their doctor what medications they are on (such as biological agents and steroids) and whether they have any underlying health conditions, including diabetes or chronic heart, lung, or kidney diseases
A person should let the doctor know that they have psoriasis even if their skin lesions are not obvious (in remission or the skin lesions are concealed as in flexural psoriasis).
COVID-19 can be effectively managed with proper medications and other supportive treatment even in people with psoriasis.
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National Psoriasis Foundation/USA. COVID-19 Task Force Guidance Statements. https://www.psoriasis.org/covid-19-task-force-guidance-statements/
Gisondi P, Bellinato F, Chiricozzi A, Girolomoni G. The Risk of COVID-19 Pandemic in Patients with Moderate to Severe Plaque Psoriasis Receiving Systemic Treatments. Vaccines (Basel). 2020 Dec 2;8(4):728. https://pubmed.ncbi.nlm.nih.gov/33276686/
Feldman SR. Treatment of psoriasis in adults. UpToDate. https://www.uptodate.com/contents/treatment-of-psoriasis-in-adults#H2973159656
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