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The ‘psoriatic march’: a concept of how severe psoriasis may drive cardiovascular comorbidity
Author(s) -
Boehncke WolfHenning,
Boehncke Sandra,
Tobin AnneMarie,
Kirby Brian
Publication year - 2011
Publication title -
experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.108
H-Index - 96
eISSN - 1600-0625
pISSN - 0906-6705
DOI - 10.1111/j.1600-0625.2011.01261.x
Subject(s) - psoriasis , medicine , psoriatic arthritis , comorbidity , disease , rheumatoid arthritis , myocardial infarction , systemic inflammation , stroke (engine) , insulin resistance , diabetes mellitus , dermatology , intensive care medicine , inflammation , obesity , endocrinology , mechanical engineering , engineering
There is increasing awareness that psoriasis is more than ‘skin deep’. Several recent reviews focussed on biomarkers indicating the systemic dimension of psoriasis and the aspect of comorbidity psoriasis shares with other chronic inflammatory diseases, such as Crohn’s disease and rheumatoid arthritis. Of emerging significance is the relationship to cardiovascular disease, as this contributes substantially to the patients’ increased mortality. In this viewpoint, we examine currently available evidence favouring the concept of a causal link between psoriasis and cardiovascular disease: systemic inflammation may cause insulin resistance, which in turn triggers endothelial cell dysfunction, leading to atherosclerosis and finally myocardial infarction or stroke. While this ‘psoriatic march’ is not yet formally proven, it raises clinically and academically relevant questions, and gains support by recent observations of numerous investigators.