Psoriasis

Psoriasis is a common inflammatory condition involving the skin, scalp, nails, and joints. It significantly increases the risk of cardiovascular events and death in those affected, above Framingham Risk Score prediction alone.1 There is a dose-response element; those with the most severe psoriasis (assessed by the psoriasis area severity index score) are at the greatest risk. A UK study estimated the excess risk as being equivalent to having a diagnosis of diabetes mellitus.2 Psoriasis often becomes apparent at a young age, exposing patients to higher risk for several decades. This translates into a lifetime excess of cardiovascular mortality of ≈2.3See accompanying article on page 2667 Psoriasis and atherosclerosis share many pathological pathways. These include T-helper cell activation, an excess of Th-1 cytokines, and imbalances in the interleukin 1 pathway favoring inflammation.4 As well as driving atherothrombosis, there is evidence that psoriasis patients have an excess of both aortic valve stenosis and arterial stiffening, both conditions believed to have inflammatory bases.5,6In this edition of Atherosclerosis, Thrombosis, and Vascular Biology …