- Beyond the skin
Understanding psoriasis and its associated comorbidities is key to providing the right treatment and referral to patients when needed.[1]
Patients with psoriasis have >50% greater risk for stroke or myocardial infarction compared with the general population.[2]
Severe psoriasis may be associated with a higher risk of cardiovascular mortality, and patients with psoriasis for more than 8 years may have a higher prevalence of coronary heart disease.[3][4]
Compared with the general population, people with psoriasis have a 2.9-fold increased risk of developing Crohn's disease.[5]
People with Crohn's disease have a 7-fold increased risk of developing psoriasis.[5]
The more severe psoriasis is, the stronger the association with metabolic syndromes, such as central obesity, dyslipidemia, and insulin resistance.[5]
Weight loss can improve the condition (as obesity may play some role in triggering psoriasis), however, it may not be sufficient alone to control the disease.[5]
~30% of patients with psoriasis develop PsA in their lifetime[6], and up to 20% of people with PsA suffer from severe joint deformities.[5] People with PsA have an increased rate of mortality (+59% in women, +65% in men).[5]
Skin involvement usually precedes arthritis in 75% of cases, and nail changes are seen in up to 90% of people with PsA.[5]
Biologics such as IL-23 inhibitors may help improve the condition of your patients with both skin and joints involvement.[7]
People with psoriasis have a higher prevalence of Obstructive Sleep Apnea/ Hypopnea Syndrome (OSAHS) compared with the general population.[5]
This association could be due to obesity, although the involvement of inflammatory mediators cannot be excluded.[5]
~2% of people with psoriasis develop intraocular inflammatory disease, especially uveitis.[5]
Although not as frequent as other comorbidities, uveitis is insidious and may lead to complications, such as retinal vasculitis, if left untreated.[5]
Every type of psoriasis is different.
Different treatments address different needs.