Psoriasis beyond the skin: a review of the literature on cardiometabolic and psychological co-morbidities of psoriasis

Psoriasis is increasingly associated with a range of co-morbid diseases and risk factors. Patients with co-morbidities are more likely to need hospitalisation for non-dermatological conditions, and incur greater total costs than those without co-morbidities. A literature review was conducted on two of the most common co-morbidities of psoriasis (cardiovascular (CV) and psychological co-morbidities), to establish their incidence and impact and to raise awareness of unanswered questions and highlight knowledge gaps. A large number of small controlled or cross-sectional studies report increased prevalence of cardiometabolic and psychological co-morbidities in psoriasis patients.Anumber of large cohort studies documented the incidence of various cardiometabolic comorbidities. Severe psoriasis is associated with increased mortality, and the most common cause of death is CV disease. Studies on the management of co-morbidities and their impact on psoriasis treatment are scarce. Many questions on the co-morbidities of psoriasis remain to be answered.