title: The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity.
abstract: There is increasing awareness that psoriasis is more than 'skin deep'. Several recent reviews focussed on biomarkers indicating the systemic dimension of psoriasis and the aspect of comorbidity psoriasis shares with other chronic inflammatory diseases, such as Crohn's disease and rheumatoid arthritis. Of emerging significance is the relationship to cardiovascular disease, as this contributes substantially to the patients' increased mortality. In this viewpoint, we examine currently available evidence favouring the concept of a causal link between psoriasis and cardiovascular disease: systemic inflammation may cause insulin resistance, which in turn triggers endothelial cell dysfunction, leading to atherosclerosis and finally myocardial infarction or stroke. While this 'psoriatic march' is not yet formally proven, it raises clinically and academically relevant questions, and gains support by recent observations of numerous investigators.
authors.affiliation: Department of Dermatology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, Frankfurt am Main, Germany. Boehncke@em.uni-frankfurt.de
authors.forename: Wolf-Henning
authors.initials: WH
authors.lastname: Boehncke
authors.forename: Sandra
authors.initials: S
authors.lastname: Boehncke
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Tobin
authors.forename: Brian
authors.initials: B
authors.lastname: Kirby
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D002908:Chronic Disease; D016207:Cytokines / Q000502:physiology; D018450:Disease Progression; D042783:Endothelial Cells / Q000473:pathology / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007333:Insulin Resistance / Q000502:physiology; D011565:Psoriasis / Q000150:complications*
chemical_list: D016207:Cytokines