A number of conditions are associated with psoriasis, so effective management must take these into consideration. Psoriasis disease-related comorbidities include hypertension and cardiovascular diseases, obesity, type 2 diabetes, non-alcoholic fatty liver disease, anxiety, depression, and inflammatory bowel disease.
Are comorbidities actually part of the systemic disease? Find out more from Professor Ulrich Mrowietz.
This section of the Psoriasis Learning Zone will provide an overview of some of the comorbidities associated with psoriasis, their impact on mortality and address the link between psoriatic arthritis and comorbidities.
Psoriasis comorbidities references
Abedini R, Salehi M, Lajevardi V, Beygi S. Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease. Clin Exp Dermatol. 2015;40:722–7.
Benson MM, Frishman WH. The heartbreak of psoriasis: a review of cardiovascular risk in patients with psoriasis. Cardiol Rev. 2015;23:312–6.
Blegvad C, Nybo Andersen AM, Adam A, Zachariae C, Skov L. Psoriasis as a predictor of cardiometabolic comorbidity in women: a study based on the Danish National Birth Cohort. Acta Derm Venerol. 2019;99(3):274–278.
Boehncke WH, Boehncke S. More than skin-deep: the many dimensions of psoriatic disease. Swiss Med Wkly. 2014;144:w13968.
Boehncke WH, Gladman DD, Chandran V. Cardiovascular comorbidities in psoriasis and psoriatic arthritis: pathogenesis, consequences for patient management, and future research agenda: a report from the GRAPPA 2009 annual meeting. J Rheumatol. 2011;38(3):567–71.
Boehncke WH. Systemic inflammation and cardiovascular comorbidity in psoriasis patients: causes and consequences. Front Immunol. 2018;9:579.
Brauchli YB, Jick SS, Miret M, Meier CR. Psoriasis and risk of incident cancer: an inception cohort study with a nested case-control analysis. J Invest Dermatol. 2009;129(11):2604–12.
Capon F, Di Megli P, Szaub J, Prescott NJ, Dunster C, Baumber L, et al. Sequence variants in the genes for the interleukin-23 receptor (IL23R) and its ligand (IL12B) confer protection against psoriasis. Hum Genet. 2007;122:201–6.
Cargill M, Schrodi SJ, Chang M, Garcia VE, Brandon R, Callis KP, et al. A large-scale genetic association study confirms IL12B and leads to the identification of IL23R as psoriasis-risk genes. Am J Hum Genet. 2007;80:273–390.
Chen YJ, Wu CY, Chen TJ, Shen JL, Chu SY, Wang CB, et al. The risk of cancer in patients with psoriasis: a population-based cohort study in Taiwan. J Am Acad Dermatol. 2011;65(1):84–91.
Chiricozzi A, Gisondi P, Girolomoni G. The pharmacological management of patients with comorbid psoriasis and obesity. Expert Opin Pharmacother. 2019;20(7):863–872.
Chiricozzi A, Krueger JC. IL-17 targeted therapies for psoriasis. Expert Opin Investig Drugs. 2013;22:993–1005.
Cho JH. The genetics and immunopathogenesis of inflammatory bowel disease. Nat Rev Immunol. 2008;8:458–66.
Cohen BE, Martires KJ, Ho RS. Psoriasis and the risk of depression in the US population: National Health and Nutrition Examination Survey 2009-2012. JAMA Dermatol. 2016;152(1):73–9.
Cohen SN, Baron SE, Archer CB. Guidance on the diagnosis and clinical management of psoriasis. Clin Experiment Dermatol. 2012;37(Suppl 1):13–8.
Cottone M, Sapienza C, Macaluso FS, Cannizzaro M. Psoriasis and inflammatory bowel disease. Dig Dis. 2019;10:1–7.
de Carvalho AV Duquia RP, Horta BL, Bonamigo RR. Efficacy of immunobiologic and small molecule inhibitor drugs for psoriasis: A systematic review and meta-analysis of randomized clinical trials. Drugs R D. 2017;17(1):29–51.
Edson-Heredia E, Zhu B, Guo J, Maeda-Chubachi T, Lebwohl M. Disease burden and quality of life in psoriasis patients with and without comorbid psoriatic arthritis: results from National Psoriasis Foundation panel surveys. Cutis. 2015a;95:173–8.
Edson-Heredia E, Zhu B, Lefevre C, Wang M, Barrett A, Bushe CJ, et al. Prevalence and incidence rates of cardiovascular, autoimmune, and other diseases in patients with psoriatic or psoriatic arthritis: a retrospective study using Clinical Practice Research Datalink. J Eur Acad Dermatol Venereol. 2015b;29:955–63.
Elmets CA, Leonardi CL, Davis DMR, Gelfand JM, Lichten J, Mehta NN, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol. 2019a;80(4):1073–1113.
Fu Y, Lee CH, Chi CC. Association of psoriasis with inflammatory bowel disease: a systematic review and meta-analysis. JAMA Dermatol. 2018;154:1417–23.
Fujino S, Andoh A, Bamba S, Ogawa A, Hata K, Araki Y, et al. Increased expression of interleukin 17 in inflammatory bowel disease. Gut. 2003;52:65–70.
Griffiths CEM, Jo SJ, Naldi L, Romiti R, Guevara-Sangines E, Howe T, et al. A multidimensional assessment of the burden of psoriasis: results from a multinational dermatologist and patient survey. Br J Dermatol. 2018;179(1):173–181.
Hu SC, Yuan SF, Chen GS, Tu HP. Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study. J Eur Acad Dermatol Venereol. 2019;33(8):1547–1554.
Machado-Pinto J, Diniz Mdos S, Bavoso NC. Psoriasis: new comorbidities. An Bras Dermatol. 2016;91(1):8–14.
Maddur MS, Miossec P, Kaveri SV, Bayry J. Th17 cells: biology, pathogenesis of autoimmune and inflammatory diseases, and therapeutic strategies. Am J Pathol. 2012;181:8–18.
Maybury CM, Porter HF, Kloczko E, Duckworth M, Cotton A, Thornberry K et al. Prevalence of advanced liver fibrosis in patients with severe psoriasis. JAMA Dermatol. 2019;155:1028–1032.
Mehta NN, Krishnamoorthy P, Yu Y, Khan O, Raper A, Van Voorhees A, Troxel AB, et al. The impact of psoriasis on 10-year Framingham risk. J Am Acad Dermatol. 2012;67(4):796–8.
Mehta NN, Yu Y, Pinnelas R, Krishnamoorthy P, Shin DB, Troxel AB, Gelfand JM. Attributable risk estimate of severe psoriasis on major cardiovascular events. Am J Med. 2011;124(8):775.e1–6.
Mendes VS, Cota LOM, Costa AA, Oliveira AMSD, Costa FO. Periodontitis as another comorbidity associated with psoriasis: A case-control study. J Periodontol 2019;90(4):358–366.
Psoriasis and inflammatory bowel disease. Dig Dis. 2019:1–7.
Shah K, Paris M, Mellars L, Changolkar A, Mease PJ. Real-world burden of comorbidities in US patients with psoriatic arthritis. RMD Open. 2017;3(2):e000588.
Siegel D, Devaraj S, Mitra A, Raychaudhuri SP, Raychaudhuri SK, Jialal I. Inflammation, atherosclerosis, and psoriasis. Clin Rev Allergy Immunol. 2013;44(2):194–204.
Skroza N, Proietti I, Pampena R, La Viola G, Bernardini N, Nicolucci F, et al. Correlations between psoriasis and inflammatory bowel diseases. Biomed Res Int. 2013:983902.
Svedbom A, Dalén J, Mamolo C, Cappelleri JC, Mallbris L, Petersson IF, et al. Increased Cause-specific Mortality in Patients with Mild and Severe Psoriasis: A Population-based Swedish Register Study. Acta Derm Venereol. 2015 5;95:809–15.
Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS et al. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol. 2017;76(3):377–90.