Psoriasis and comorbid diseases : Epidemiology - 18/04/17

Doi : 10.1016/j.jaad.2016.07.064

Junko Takeshita, MD, PhD, MSCE ^a,^b,^⁎ , Sungat Grewal, BS ^a, Sinéad M. Langan, MB, BCh, BAO, MRCP, MSc, PhD ^c, Nehal N. Mehta, MD, MSCE ^d, Alexis Ogdie, MD, MSCE ^b,^e, Abby S. Van Voorhees, MD ^f, Joel M. Gelfand, MD, MSCE ^a,^b
^a Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
^b Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
^e Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
^c London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom
^d National Heart, Lung and Blood Institute, Bethesda, Maryland
^f Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia

^∗Correspondence to: Junko Takeshita, MD, PhD, MSCE, Department of Dermatology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Perelman Center for Advanced Medicine, 7th Floor, South Tower, Office 728, Philadelphia, PA 19104.Department of DermatologyUniversity of Pennsylvania Perelman School of Medicine3400 Spruce St.3400 Civic Center Boulevard, Perelman Center for Advanced Medicine, 7th Floor, South Tower, Office 728PhiladelphiaPA19104

Abstract

Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.

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Key words : cardiovascular disease, chronic kidney disease, comorbidities, Crohn's disease, depression, metabolic syndrome, nonalcoholic fatty liver disease, psoriasis, psoriatic arthritis, lymphoma, infection

Abbreviations used : BMI, BSA, CAD, CD, CEC, CHD, CKD, CTCL, CV, CVD, ESRD, FDG, FRS, HDL, IBD, IHD, MACE, MI, NAFLD, NASH, NMSC, OR, PET/CT, PsA, RA, RR, UC

Plan

Introduction

Cardiometabolic disease

Major adverse cardiovascular events

Gastrointestinal disease

Inflammatory bowel disease

Hepatic disease

Chronic kidney disease

Emerging comorbidities

	Supported in part by National Institute of Arthritis and Musculoskeletal and Skin Diseases grants K24AR064310 (Dr Gelfand), T32AR00746532 (Ms Grewal), K23AR063764 (Dr Ogdie), and K23AR068433 (Dr Takeshita), a Dermatology Foundation Career Development Award (Dr Takeshita), the Intramural Research Program at the National Institutes of Health grant ZIAHL006193-02 (Mehta), and a National Institute for Health Research Clinician Scientist Fellowship (grant NIHR/CS/010/014 to Dr Langan). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the UK Department of Health.
	Dr Takeshita has received a research grant (to the Trustees of the University of Pennsylvania) from Pfizer Inc and payment for continuing medical education work related to psoriasis. Dr Mehta is a full-time employee of the US Government. Dr Ogdie receives research grants from AbbVie (to the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis [GRAPPA]), Celgene (to GRAPPA), and Pfizer Inc (to the Trustees of the University of Pennsylvania and GRAPPA), and has served as a consultant for Novartis, receiving honoraria. Dr Van Voorhees has served as a consultant for AbbVie, Amgen, Aqua, AstraZeneca, Celgene, Corrona, Dermira, Janssen, Leo, Novartis, and Pfizer, receiving honoraria; received a research grant from AbbVie; and has other relationship with Merck. Dr Gelfand has served as a consultant for AbbVie, AstraZeneca, Celgene Corp, Coherus, Eli Lilly, Janssen Biologics (formerly Centocor), Sanofi, Merck, Novartis Corp, Endo, and Pfizer Inc, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from AbbVie, Amgen, Eli Lilly, Janssen, Novartis Corp, Regeneron, and Pfizer Inc; and received payment for continuing medical education work related to psoriasis. Dr Gelfand is a co–patent holder of resiquimod for treatment of cutaneous T-cell lymphoma. No other potential conflicts of interest were declared by the authors.
	Date of release: March 2017
	Expiration date: March 2020