Psoriasis and diabetes: a review of the pathophysiological and therapeutic interconnections

Abstract

Introduction: Psoriasis is a chronic, immune-mediated skin disorder associated with systemic conditions like cardiovascular diseases, metabolic syndrome, and type 2 diabetes mellitus. Individuals with psoriasis show a higher risk of diabetes compared to the general population. This review aims to examine the relationship between the physiopathology and treatment of psoriasis and diabetes mellitus.

Evidence acquisition: A systematic search was conducted across PubMed and Google Scholar up to July 2024. Observational studies and clinical trials involving all age groups and genders were included, focusing on the pathophysiology, inflammatory pathways, and therapeutic interventions for psoriasis and diabetes.

Evidence synthesis: Evidence consistently showed an increased prevalence of type 2 diabetes among psoriasis patients. The IL-23/IL-17 axis plays a critical role in the inflammation driving both psoriasis and insulin resistance. This inflammation promotes metabolic syndrome components such as obesity. Conversely, insulin resistance and obesity amplify systemic inflammation, creating a vicious cycle in psoriasis patients. Integrated treatment approaches, combining targeted pharmacologic therapies with lifestyle modifications, demonstrated potential in managing both conditions effectively. Multidisciplinary care is vital to address the dermatological and metabolic aspects of these interconnected diseases.

Conclusions: The shared inflammatory pathways between psoriasis and type 2 diabetes highlight the complex, bidirectional relationship between the two. Integrated therapeutic strategies that include lifestyle changes and targeted drug interventions show promise in improving outcomes for individuals affected by both conditions.