Skin diseases may have complications that can change a person's life. Patients need to know and to watch for these complications and check in at least once or twice a year with their doctors.
I saw a woman the other day who had probably some of the worst looking skin I have ever seen. She thought it was all due to aging and yet she was probably just in her late sixties. She had psoriasis on her elbows and knees and considerable discoloration all over with many spots of different colors. She said she saw a dermatologist once a year, but had never been told to use sun screen lotion or to wear a hat when she was outdoors. I was amazed. She also had not been told of any of the secondary problems that can occur with psoriasis. I would hope that a dermatologist would talk with a patient's primary doctor when he or she makes the diagnosis of psoriasis, because there are several problems that need to be considered. Arthritis can occur with these patients, as can Type 2 diabetes, hypertension, a three times greater risk of heart attacks, Crohn's disease, eye problems, uveitis, kidney disease and Parkinson's.
I had a wonderful secretary many years ago who had severe psoriasis. She knew about all the possible problems and was very diligent about checking in with her internist. Communication these days between doctors, despite electronic records seems to be a lost art in many parts of the country. I have spent many hours dictating letters and making telephone calls about patients. Now I hear from many former patients who tell me that their doctors don't seem to know who they are, what problems they are having and seem to have little interest. When a patient has multiple problems, this appears to be an even greater problem. Thus, I think patients with skin disorders need to do some research, talk with their primary doctors and find out if there are any problems they should watch for. They should also see a dermatologist at least twice a year.