Psoriasis Comorbidities: Results from the National Psoriasis Foundation Surveys 2003 to 2011

Abstract

Background: Studies examining comorbidities among psoriasis patients with varying disease severities measured by body surface area (BSA) are lacking. Objective: To examine the association between psoriasis severity and comorbid conditions, including rheumatologic, cardiovascular and other immune-mediated diseases. Methods: From 2003 to 2011, the National Psoriasis Foundation conducted surveys among 5,604 psoriasis patients. The combined surveys represented the largest study to date that used BSA as a direct measure of psoriasis severity for comorbidity assessment. Results: Over 86% of psoriatic arthritis (PsA) patients reported presenting with psoriasis prior to PsA; the diagnosis of psoriasis preceded that of PsA by a mean period of 14.6 years. Compared to those with mild psoriasis, patients with moderate-to-severe psoriasis had significantly increased adjusted odds of PsA (moderate: odds ratio, OR: 1.21, 95% confidence interval, CI: 1.04–1.41; severe: OR: 2.32, 95% CI: 1.98–2.70). Patients with severe psoriasis had increased adjusted odds of diabetes (OR: 1.5, 95% CI: 1.08–2.08) and cardiovascular disease (OR: 1.5, 95% CI: 1.01–2.24) compared to those with mild-to-moderate psoriasis. Odds of rheumatoid arthritis, ankylosing spondylitis, lupus, Crohn’s disease and multiple sclerosis were not significantly increased in patients with severe psoriasis. Conclusion: Compared to those with mild-to-moderate psoriasis, patients with severe psoriasis are at increased odds of PsA, diabetes and cardiovascular diseases.

IL12B (p40) Gene Polymorphisms Contribute to Ustekinumab Response Prediction in Psoriasis

“…red scaly patches, can cover various areas of the body, making it easy to notice and thus stigmatizing, with an important impact on the patient's quality of life [4]. Furthermore, this condition may cause significant morbidity due to the coexistence of psoriatic arthritis in approximately one third of the patients and an association with a large number of systemic diseases [5,6]. …”

Frequency of fragmented QRS in patient with psoriasis vulgaris without cardiovascular disease

“…Additionally, they found higher incidences of hyperlipidemia, obesity, and hypertension even in patients with juvenile psoriasis [4]. However, there are also studies showing that the disease itself alone presents a risk even if there are no cardiovascular risk factors and comorbidities of the disease in psoriasis patients [1,2,15,18]. Ahlehoff et al reported that psoriasis is a risk factor for cardiovascular disease independent of age, sex, comorbidities of the disease, administered systemic treatments, and socioeconomical status.…”

“…Additionally they found this risk was higher in young age, severe disease and presence of psoriatic arthritis [1]. Armstrong et al determined that cardiovascular disease risk was 1.5 fold higher in patients with severe psoriasis when compared to mild and moderate psoriasis [2]. Gelfand et al reported psoriasis was a risk factor by itself for development of myocardial infarction (MI), after following up their patients for average of 5.4 years.…”

“…Cardiovascular comorbidities of the disease have been known for a long time; nearly 37 years ago it was reported that occlusive vascular diseases were more frequent and cardiovascular mortality was higher in psoriasis patients [21]. In addition, even if there is not classical cardiovascular risk factors and cormorbidities of the disease, studies suggest the disease itself constitutes a risk [1,2,15,18].…”

Evaluation of Tp-e interval and Tp-e/ QTc ratio in patients with mild to moderate psoriasis

“…Despite the precise pathogenesis underlying psoriasis are not yet fully elucidated, systemic inflammatory response and oxidative stress are considered the most important mechanisms in the disease's development [15,16]. Many systemic diseases including diabetes, hypertension, cardiovascular disturbances have been described in psoriatic patients [2][3][4][5].…”