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Comorbidities


Comorbidities in


moderate to severe psoriasis


The prevalence of comorbidities in patients with psoriasis, the potential mechanisms for the association between psoriasis and comorbidities, and the known effects of therapy are discussed


Marvin Kuske MD Petra Spornraft-Ragaller MD Stefan Beissert MD Department of Dermatology, University of Dresden, Germany


At present, psoriasis is regarded not only as a skin disease but also as a systemic disorder with multiple associated comorbidities. To draw attention to the public health impact of psoriasis, in May 2014, the World Health Organisation put psoriasis on the list of serious non-communicable diseases. This article, based on current data, provides a short review of the prevalence of comorbidities in patients with psoriasis, the potential mechanisms for the association between psoriasis and comorbidities, and the known effects of therapy on the associated comorbidities.


Comorbidities Psoriatic arthritis


Psoriatic arthritis (PsA) is the most well-known comorbidity of psoriasis. The prevalence of PsA in the general population is estimated to be 0.04–1.2%, whereas the prevalence of PsA in psoriatic patients is estimated to be between 25% and 34%.1


Obesity


Several studies were able to demonstrate an increased prevalence of obesity, which is generally defined as a body mass index (BMI) ≥30kg/m2


, among


patients with psoriasis. However, it is not clear whether obesity is a result of psoriasis or a contributing factor.2 population-based study on 127,706


A


“The chronic systemic inflammatory state underlying psoriasis seems to be the central causal factor for most of the associated comorbidities”


patients with mild psoriasis and 3854 patients with severe psoriasis showed an increased prevalence of obesity in patients with mild (odds ratio (OR): 1.27; 95% confidence interval (CI): 1.24–1,31) and severe psoriasis (OR: 1.79; 95% CI: 1.55–2.05). There was a strong association with disease severity (severe versus mild psoriasis: OR 1.47; 95% CI: 1.32–1.63).3


In a systematic review and


meta-analysis of observational studies published between 1980 and 2012, the pooled OR for obesity of patients with


psoriasis compared with controls without psoriasis was 1.66 (95% CI: 1.46–1.89).4


Altogether, obesity seems to


be prevalent especially in patients with severe psoriasis.


Metabolic syndrome


The association between psoriasis and the metabolic syndrome or components of the metabolic syndrome has been demonstrated by multiple epidemiological studies.2


review and meta-analysis of 12 www.hospitalpharmacyeurope.com


In a systematic 11


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