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Review
. 2021 Jun;48(6):732-740.
doi: 10.1111/1346-8138.15840. Epub 2021 Mar 25.

Psoriasis: Comorbidities

Fumikazu Yamazaki  1
Affiliations
Review

Psoriasis: Comorbidities

Fumikazu Yamazaki. J Dermatol. 2021 Jun.

Abstract

Psoriasis has long been known as a disease with many complications, but was attributed to diet and obesity. However, in recent years, psoriasis itself has been recognized as a series of systemic inflammatory diseases, and that the cytokines involved can induce a variety of other diseases. Individuals with psoriasis were also found to have higher incidences of cerebral and cardiovascular diseases and a younger age at death compared to healthy individuals. However, no clear guidelines have been defined regarding how much vascular lesion testing should be performed in patients with psoriasis. In this report, I attempt to unravel the objective data on psoriasis and its complications from various reviews and reports, and introduce the impact of biologics, which are currently the main treatment for psoriasis, on cardiac vascular disease.

Keywords: complication; major adverse cardiovascular disease; metabolic syndrome; psoriasis.

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Figures

Figure 1
Figure 1
Immune cells and lipoprotein‐associated cytokines implicated in psoriasis pathogenesis. Abbreviations: Apo, apolipoprotein; apoA‐1, apolipoprotein A1; apoM‐1, apolipoprotein M1; CAMP, cathelicidin antimicrobial peptide; CE, cholesteryl ester; CETP, cholesteryl ester transfer protein; DC, dendritic cell; HDL, high‐density lipoprotein; IFN, interferon; IL, interleukin; LDL, low‐density lipoprotein; ox‐LDL, oxidized LDL; PGE‐2, prostaglandin E2; PON, paraoxonase; SAA, serum amyloid A; SD‐LDL, small dense LDL; TNF‐α, tumor necrosis factor‐α; Th1, T‐helper cell type 1; Th17, T‐helper cell type 17; Th22, T‐helper cell type 22; TG, triglyceride
Figure 2
Figure 2
The concept of psoriatic march. Psoriasis causes not only skin inflammation but also systemic inflammation, leading to increased insulin resistance, vascular endothelial damage, atherosclerosis, and myocardial infarction. This sequence of events is known as the psoriatic march. Obesity is an aggravating factor in this process, and continuous systemic treatment is a suppressing factor
Figure 3
Figure 3
A case of psoriasis in which coronary artery stenosis was improved by the use of anti‐interleukin (IL)‐17 antibody. (a) Coronary stenosis with non‐calcified plaque in the left anterior descending artery (red arrow) and severe stenoses with interruption in the right posterior descending artery (white arrows) before treatment. (b) High magnification of the boxed section: attenuation of contrast effect in both left anterior descending artery (red arrow) and posterior descending artery (white arrow) before treatment. (c) Improvement of coronary stenosis in both left anterior descending artery (red arrow) and posterior descending artery (white arrows) after treatment. (d) High magnification of the boxed section: attenuation in both left anterior descending artery (red arrow) and posterior descending artery (white arrow) is improved after treatment
See this image and copyright information in PMC

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