Psoriasis: classical and emerging comorbidities

Abstract

Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis.

Comorbidities in psoriasis: The recognition of psoriasis as a systemic disease and current management

“…This is a frequent comorbidity; there is undiagnosed psoriatic arthritis in many psoriasis patients. As early diagnosis and treatment would prevent erosive arthropathy and irreversible joint destruction, psoriatic patients should be screened for this condition and observed in respect of development of psoriatic arthritis 4,7,8 . Pain, rigidity, swelling and tenderness of joints showing inflammatory pain, back pain and stiffness, and joint pain accompanied by morning stiffness should be especially looked for at examination.…”

“…There are several classifications of comorbidities in psoriasis. Although comorbidities can be simply classified as classical, related to chronic systemic inflammation, lifestyle and treatment 4 ( Figure 1), they can be classified as medical comorbidities, psychiatric/psychological comorbidities and conditions contributing to comorbidities (Figure 2…”

Psoríase e Doença Cardiovascular: Impacto da Terapêutica com Inibidores do TNF-alfa

“…Como doença sistémica associa-se a múltiplas comorbilidades, das quais se destacam as cardiometabólicas. [1][2][3] Apesar de não ser inequívoco que a psoríase seja um fator de risco independente de doença cardiovascular, existe forte evidência de uma associação com doenças cardiovasculares não se conhecendo ainda, na sua totalidade, os mecanismos responsáveis por esta associação. 4 Recentemente tem-se procurado perceber qual o papel da terapêutica sistémica na redução do risco de doença cardiovascular e na prevenção da doença aterotrombótica.…”

The experience of complex pharmacotherapy of psoriasis in combination with plasmapheresis

“…Псориатический артрит может предшествовать высыпаниям на коже, дебютировать одновременно или наступить после кожных проявлений. В 75% случаев поражение кожи предшествует артриту, в 10% происходит одновременно, в 15% случаев псо-риатический артрит может предшествовать высыпа-ниям на коже -в такой ситуации при постановке диагноза необходимо ориентироваться на семейный анамнез [5]. Причины поражения суставов остаются невыясненными.…”

“…Экспериментальные и клинические данные свидетельствуют о наличии связи псориаза с артритом, воспалительными заболеваниями кишеч-ника, сердечно-сосудистыми заболеваниями, мета-болическим синдромом (ожирение, гипертриглице-ридемия, гипергликемия, артериальная гипертен-зия, инсулинорезистентность), депрессией, неалко-гольной жировой болезнью печени, злокачествен-ными новообразованиями и заболеваниями. Не так давно в качестве патологии, ассоциированной с со-стоянием хронического воспаления при псориазе, предложены и другие расстройства [5].…”