The Association Between Psoriasis and Metabolic Syndrome in Children: A Narrative Review

Psoriasis is a common inflammatory skin disease with a complex pathogenesis consisting of genetic factors, immune dysfunction and environmental background. In adults, psoriasis is strongly associated with a higher risk of developing metabolic abnormalities; however, data in children are inconclusive. Metabolic syndrome (MetS) is a group of conditions that include central and abdominal obesity, hypertension, dyslipidemia and hyperglycemia. Potential pathogenic mechanisms linking psoriasis with metabolic syndrome include releasing large amounts of proinflammatory cytokines such as interleukins (IL-17, IL-23) and tumor necrosis factor alpha (TNF-alpha). These abnormalities promote excessive keratinocyte proliferation and impaired differentiation, which leads to typical psoriatic skin lesions. This paper aims to assess the potential link between psoriasis and each component of metabolic syndrome in children. It is speculated that the same proinflammatory cytokines produced by Th17 cells are also implicated in the development and progression of various metabolic disorders in patients with a severe course of the disease. Psoriatic patients are at higher risk for development metabolic diseases such as diabetes mellitus and cardiovascular disease.