Psoriasis is a disease with varying degrees of severity. Some clinicians regard the disease as a mild cutaneous illness, the manifestations of which are considered to be limited to slight discomfort or even simply aesthetic concerns. Unfortunately, this view may lead to inadequate treatment. Severe psoriasis can present in dangerous forms such as erythrodermic and pustular psoriasis. In addition, the disease is associated with a number of significant systemic comorbidities. Aside from the profound psychological and physical impact on the patient's everyday life, psoriasis can affect the joints and cardiac and vascular systems, and has even been associated with the metabolic syndrome. This article discusses the numerous serious associations of psoriasis.
BatesD.W., SchmittW., BuchwaldD., WareN.C., LeeJ., ThoyerE., KornishR.J., KomaroffA.L.Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Arch Intern Med.1993 Dec; 153(24): 2759–65.
5.
PawlikowskaT., ChalderT., HirschS.R., WallaceP., WrightD.J., WesselyS.C.Population based study of fatigue and psychological distress. BMJ1994 Mar; 308(6931): 763–6.
6.
HustedJ.E., TomB.D., SchentagC.T., FarewellV.T., GladmanD.D.Occurrence and correlates of fatigue in psoriatic arthritis. Ann Rheum Dis.2009 Oct; 68(10): 1553–8.
7.
KayeJ.A., LiL., JickS.S.Incidence of risk factors for myocardial infarction and other vascular diseases in patients with psoriasis. Br J Dermatol.2008 Sep; 159(4): 895–902.
8.
GelfandJ.M., NeimannA.L., ShinD.B., WangX., MargolisD.J., TroxelA.B.Risk of myocardial infarction in patients with psoriasis. JAMA.2006 Oct 11; 296(14): 1735–41.
9.
GelfandJ.M., DommaschE.D., ShinD.B., AzfarR.S., KurdS.K., WangX., TroxelA.B.The risk of stroke in patients with psoriasis.2009 Oct; 129(10): 2411–8.
10.
GisondiP., TessariG., ContiA., PiasericoS., SchianchiS., PesericoA., GiannettiA., GirolomoniG.Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol.2007 Jul; 157(1): 68–73.
11.
DreiherJ., WeitzmanD., DavidoviciB., ShapiroJ., CohenA.D.Psoriasis and dyslipidaemia: a population-based study. Acta Derm Venereol.2008; 88(6): 561–5.
MurrayM.L., BergstresserP.R., Adams-HuetB., CohenJ.B.Relationship of psoriasis severity to obesity using same-gender siblings as controls for obesity. Clin Exp Dermatol.2009 Mar; 34(2): 140–4.
14.
SettyA.R., CurhanG., ChoiH.K.Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses' Health Study II. Arch Intern Med.2007 Aug 13–27; 167(15): 1670–5.
15.
HornL.Psoriasis impacts daily life and carries a substantial burden: National Psoriasis Foundation Survey Panels. Poster presented at 64th Annual American Academy of Dermatology 2006; March 3–7, 2006; San Francisco, Calif., Poster P2833.
ChenY.J., WuC.Y., ShenJ.L., ChuS.Y., ChenC.K., ChangY.T., ChenC.M.Psoriasis independently associated with hyperleptinemia contributing to metabolic syndrome. Arch Dermatol.2008 Dec; 144(12): 1571–5.
19.
ChenY.J., ShenJ.L., WuC.Y., ChangY.T., ChenC.M., LeeF.Y.Elevated plasma osteopontin level is associated with occurrence of psoriasis and is an unfavorable cardiovascular risk factor in patients with psoriasis. J Am Acad Dermatol.2009 Feb; 60(2): 225–30.
20.
KaurS., ZilmerK., KairaneC., KalsM., ZilmerM.Clear differences in adiponectin level and glutathione redox status revealed in obese and normal-weight patients with psoriasis. Br J Dermatol.2008 Dec; 159(6): 1364–7.
21.
Datamonitor, “Diagnosis and Treatment Options.” Stakeholder insight: Psoriasis biologics impact treatment regimes across the globe (2005): 59–76.
22.
Datamonitor, “Improving Treatment Outcomes.” Stakeholder insight: Psoriasis biologics impact treatment regimes across the globe (2005): 124–150.
23.
StroberB., TellerC., YamauchiP., MillerJ.L., HooperM., YangY.C., DannF.Effects of etanercept on C-reactive protein levels in psoriasis and psoriatic arthritis. Br J Dermatol.2008 Aug; 159(2): 322–30.
24.
MarraM., CampanatiA., TestaR., SirollaC., BonfigliA.R., FranceschiC., MarchegianiF., OffidaniA.Effect of etanercept on insulin sensitivity in nine patients with psoriasis. Int J Immunopathol Pharmacol.2007 Oct-Dec; 20(4): 731–6.
25.
ProdanovichS., MaF., TaylorJ.R., PezonC., FasihiT., KirsnerR.S.Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol.2005 Feb; 52(2): 262–7.
