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. A number of large cohort studies documented the incidence of various cardiometabolic co-morbidities. 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.