Long-term prognosis in patients with psoriasis.
Psoriasis is a chronic, inflammatory, immune-mediated skin disease associated with substantial comorbidity. Traditional comorbid conditions include psychological/psychiatric disorders, psoriatic arthritis and inflammatory bowel disease. Increasingly, an association with metabolic dysfunction, including obesity and the metabolic syndrome, and cardiovascular disease, with consequent effects on morbidity and mortality, has been recognized in psoriasis. The underlying inflammatory mechanisms of both psoriasis and psoriasis-associated comorbidities involve mediation by proinflammatory T-helper type 1 cytokines. For effective management of psoriasis and related comorbidities, an integrated approach targeting both cutaneous and systemic inflammation may be beneficial, and strategies to improve overall management of the patient should be encouraged to reduce the disease burden. This paper discusses the emerging role of biological agents in this approach, and offers an appreciation of the role of existing anti-psoriasis and adjunctive therapies.
Gulliver
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Newlab Clinical Research Inc., 1 Paton Street, Suite 007, St. John's NL, Canada. drgulliver@newlabresearch.com
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008019:Life Style; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications; D011379:Prognosis; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha