Are individuals diagnosed with psoriasis at an increased risk for developing the shingles virus due to their psoriasis? We reviewed the literature to find out more about shingles and psoriasis and whether or not there exists evidence of a relationship.
Before examining if there is a relationship between the two conditions, let’s first distinguish the differences between the two. While both shingles and psoriasis are serious skin conditions that can affect large areas of the body and both can cause symptoms of pain and itching, they are quite different conditions.
Psoriasis a chronic autoimmune condition that does not have a cure. The most common type of psoriasis is called plaque psoriasis and affects 80-90% of people with the condition. Plaque psoriasis causes the buildup of plaques which are inflamed, red and raised areas of skin that often have a layer of silvery scales. Plaques are the result of the body’s immune system overacting and attacking healthy cells as if there was an infection. The result is new skin cells growing much faster than normal and therefore building up the thick patches. Psoriasis is not contagious, unlike shingles, which can be passed to someone who is not immune to chickenpox. Shingles is spread by contact with fluid of the rash blisters that develop on the skin.1
Shingles, which is known in the medical world as Herpes Zoster, results from the dormant (or inactive) varicella virus (this is the virus that also causes Chicken Pox) becoming activated in the body. According to the CDC, approximately 1 in 3 people will develop shingles at some point in their lives.1 They also estimate that in the US there are approximately 1 million cases of shingles each year. For most individuals, the varicella virus will reside in the nervous system in a dormant state, but about one-third of people who have the dormant virus will experience the virus activating and turning into a case of shingles.1
Both psoriasis and shingles can be diagnosed by a medical professional by conducting an oral history and physical examination. A doctor may order a skin biopsy of the rash to diagnose psoriasis and rule out other conditions. A biopsy can often help diagnose the type of psoriasis since there are several kinds of psoriasis.
Is there a relationship?
Let’s revisit our original question: might there be a connection between having psoriasis and developing shingles. The answer isn’t 100% clear… If you are diagnosed with an autoimmune condition, like psoriasis, then your immune system is already compromised, which may mean that other conditions that attack the immune system, such as shingles, may be more likely to affect you.2
Some research also suggests that the combination of certain psoriatic disease treatments can raise the risk of shingles. A 2015 study published in JAMA Dermatology found that people taking a combination of methotrexate and a biologic had a significantly increased risk for shingles. This may be due to the immunosuppressive effects of these drugs.3
Treatment and prevention
While there is no cure for shingles (or psoriasis) there are treatment options for psoriasis flares and symptoms and treatment options to make individuals with shingles more comfortable and to reduce the duration of the disease.1 There is a vaccine for the Shingles virus (Herpes Zoster). It is a live vaccine, so it is best to speak with your medical team regarding the risks and benefits of getting the vaccine in relation to your psoriasis treatment plan.
Overview-Shingles (Herpes Zoster). Center for Disease Control and Prevention. Updated on March 15, 2016. Accessed on May 22, 2017. https://www.cdc.gov/shingles/about/overview.html
If Your Immune System Is Compromised, Can You Get Vaccinated?
Cleveland Clinic. Updated June 23, 2015. Accessed on May 21, 2017. https://health.clevelandclinic.org/2015/06/if-your-immune-system-is-compromised-can-you-get-vaccinated/
Bitterman, H., Cohen, A., Cohen, Y., Dreiher, J., Feldhamer, I., Greenberg-Dotan, S., Hammerman, A., Harman-Boehm, I., Moser, H., Shalom, G., Zisman, D. Systemic Therapy for Psoriasis and the Risk of Herpes Zoster. JAMA Dermatol. 2015;151(5):533-538. doi:10.1001/jamadermatol.2014.4956