National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Kimball, Alexa B.; Gladman, Dafna D.; Gelfand, Joel M.; Gordon, Kenneth B.; Horn, Elizabeth J.; Korman, Neil J.; Korver, Gretchen E; Krueger, Gerald G.; Strober, Bruce; Lebwohl, Mark

doi:10.1016/j.jaad.2008.01.006

Cited by 382 publications

(364 citation statements)

References 128 publications

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“…The main modifications included the exclusion of arthritis, and due to insufficient information, peripheral vascular disease, hearing impairment, and visual impairment. To reflect current literature on comorbidities in psoriasis without arthritis, PsA, and other chronic inflammatory rheumatic diseases (1,3,18,(22)(23)(24)(25)(26), we also determined the occurrence of hyperlipidemia and hypertension, cancer, autoimmune disorders, liver disease, and infections. The clinical database was used to identify comorbid conditions in both psoriasis without arthritis and PsA patients.…”

Section: Significance and Innovationsmentioning

confidence: 99%

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Cardiovascular and other comorbidities in patients with psoriatic arthritis: A comparison with patients with psoriasis

Husted¹,

Thavaneswaran²,

Chandran³

et al. 2011

Arthritis Care & Research

229

177

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Objective. To determine whether the presence of psoriatic arthritis (PsA) is associated with greater comorbidity, in particular cardiovascular morbidity, compared to psoriasis without arthritis. Methods. Six hundred eleven patients with PsA were recruited from the University of Toronto Psoriatic Arthritis Clinic and 449 psoriasis without arthritis patients were recruited from the University of Toronto Psoriasis Cohort. The clinical database was used to identify the prevalence of cardiovascular and other comorbidities in both PsA and psoriasis without arthritis patients. Univariate and multivariate logistic regression analyses were conducted to estimate odds ratios (ORs), comparing the odds of ever having a given comorbid disease in PsA patients with those in psoriasis without arthritis patients. Covariates included age, sex, education, smoking status, severity and duration of psoriasis, medication status, and other comorbidities. Results. The prevalence of hypertension, obesity, hyperlipidemia, type 2 diabetes mellitus, and at least 1 cardiovascular event in PsA patients was 37.1%, 30.0%, 20.7%, 12.0%, and 8.2%, respectively. This was significantly higher than in psoriasis without arthritis patients, with unadjusted ORs ranging from 1.54 to 2.59. In the multivariate analyses, hypertension remained significantly elevated (adjusted OR 2.17). PsA was also significantly associated with infections not treated with antibiotics (presumably viral), neurologic conditions, gastrointestinal disorders, and liver disease (adjusted ORs 2.83, 4.76, 21.53, and 7.74, respectively). Infections treated with antibiotics and depression/anxiety were relatively common in PsA, with a prevalence of 30.5% and 20.7%, respectively. However, this was not significantly different from psoriasis without arthritis after multivariate adjustments. Conclusion. The results suggest that inflammatory joint disease may play a role in both cardiovascular and noncardiovascular morbidity in PsA.

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Section: Significance and Innovationsmentioning

confidence: 99%

“…Most recently, a relationship between psoriasis and increased risk of myocardial infarction, cerebrovascular disease, and peripheral vascular (cardiovascular) disease has been reported (3)(4)(5). The observed excess risk appears to be greatest in younger patients and those with more severe psoriasis.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular and other comorbidities in patients with psoriatic arthritis: A comparison with patients with psoriasis

Husted¹,

Thavaneswaran²,

Chandran³

et al. 2011

Arthritis Care & Research

229

177

View full text Add to dashboard Cite

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“…Some publications show that patients with psoriasis have a higher risk of developing systemic comorbidities such as metabolic syndrome, diabetes mellitus and cardiovascular diseases [1][2][3][4] . In contrast to this statement, other authors found no association between severe psoriasis and obesity or between obesity and cardiovascular mortality in their studies 5 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for comorbidities in Czech psoriatic patients: Results of a hospital-based case-control study

Votrubová¹,

Jůzlová²,

Šmerhovský³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background.Psoriasis is now known to be associated with multiple other diseases/comorbidities -including the metabolic syndrome, atherosclerosis and gastrointestinal diseases which are all significantly higher in psoriasis patients. Research results however are highly variable and the conclusions are ambiguous. As no similar study has been performed to date in Czech psoriatic patients, this study aimed at identifying risk factors and early stages of selected diseases/comorbidities in the patients. Methods and Results. The study was designed as a hospital-based case-control study. 131 patients with chronic plaque psoriasis formed the cases and 267 patients with other skin disorders formed the controls. A comparison was made of basic demographic and anthropometric indicators, metabolic parameters, the presence of specific antibodies (ASCA, AEP, p-ANCA, AGC, EMA, ARA, t-TG, AGA) and non-specific signs of gastrointestinal diseases. The chi squared, MWU tests and binary logistical model were used to evaluate the data. The results showed significant differences (P<0.05) for the following parameters: blood pressure, waist circumference, weight, BMI values, leucocytes values, HDL cholesterol level, glycemia and gliadine antibody IgA level. All differences were to the detriment of psoriasis patients. In the binary logistical model the following parameters were associated with psoriasis: diastolic blood pressure, leucocyte value and glycemia. For all variables included in the logistical model P≤0.001. Conclusions. The results were coherent and consistent with existing data. They indicate that psoriasis is interconnected with hypertension, higher BMI and a decreased level of HDL cholesterol. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. Higher levels of gliadine IgA antibodies are one of the diagnostic markers of celiac disease. Higher values of leukocytes may be interpreted as a nonspecific indicator of gastrointestinal inflammatory diseases. The associations between psoriasis and diastolic blood pressure, BMI value and glycemia are statistically significant in the binary logistic regression model. Care for psoriatic patients should focus especially on secondary prevention of predisposing diseases.

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“…Moreover, there are hypotheses implicating the pathogen in triggering psoriasis [3]. There are also data concerning concurrent presentation of psoriasis and gastritis, duodenitis, celiac disease or inflammatory bowel disease [4][5][6]. A few authors have related psoriasis and disturbances of the incretory and excretory pancreatic functions and even acute pancreatitis [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, pro-inflammatory factors upregulated in psoriasis, especially interleukin (IL) 18, are likely to increase risk of the metabolic syndrome [15]. Previous reports have endorsed an association between psoriasis and the metabolic syndrome or lipid abnormalities [6,16,17]. Furthermore, psoriasis is believed to be an independent risk factor for subclinical atherosclerosis [6].…”

Section: Introductionmentioning

confidence: 99%

Psoriasis vulgaris and digestive system disorders: is there a linkage?

Pietrzak

Jastrzębska²,

Chodorowska³

et al. 2010

Folia Histochem Cytobiol.

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Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical antipsoriatics proved ineffective and the disease gradually progressed to a severe disseminated form. Subsequent detailed examinations revealed persistent gastroduodenitis due to H. pylori infection, pancreatic dysfunction and fatty change of the liver, although the patient denied any gastrointestinal symptoms. As a result appropriate treatment of the diagnosed digestive system disorders was added to topical antipsoriatic therapy. Within 2 weeks of treatment clinical symptoms and laboratory signs showed a marked trend to normalisation. The presented medical history seems to suggest that there may be some kind of interplay between psoriasis and digestive system disorders.

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National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Cited by 382 publications

References 128 publications

Cardiovascular and other comorbidities in patients with psoriatic arthritis: A comparison with patients with psoriasis

Cardiovascular and other comorbidities in patients with psoriatic arthritis: A comparison with patients with psoriasis

Risk factors for comorbidities in Czech psoriatic patients: Results of a hospital-based case-control study

Psoriasis vulgaris and digestive system disorders: is there a linkage?

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