Metabolic and Cardiovascular Comorbidities in Psoriasis: Revisited.

ABSTRACT

There is increasing awareness that psoriasis, as a disease, is more than ‘skin deep’ and associated with comorbidities that potentially increase morbidity and mortality, and lower quality of life. The consistency of association and the diversity of comorbidities reported in psoriasis warrants it to be labeled as a complex syndrome. Merely finding an association between psoriasis and comorbidities is not going to suffice until this evidence is put into clinical practice. The pathogenesis of psoriasis and its comorbidities is complex but several studies have revealed certain mechanisms and factors which are common to both. These shared pathogenic mechanisms solve the mystery to this comorbid association, especially with metabolic syndrome and cardiovascular disease. Studying these pathogenic links may reveal certain parameters which can be utilized as potential biomarkers in the presumptive screening of patients for the presence of comorbidities. These shared pathogenic mechanisms hold the key toward establishing a novel biomarker which can monitor both the disease severity and the associated comorbidity. Psoriasis patients with comorbidities also incur more healthcare costs, than those without comorbidities. Cardiovascular comorbidity in psoriasis incurs the greatest increase in healthcare resource use. Early detection of cardiovascular and other comorbid conditions in psoriasis can possibly reduce the morbidity, mortality, and economic burden associated with the disease. We attempt to review the pathogenic links between psoriasis and its metabolic and cardiovascular comorbidities.