title: Management of moderate to severe psoriasis in patients with metabolic comorbidities.
abstract: Psoriasis is a chronic inflammatory skin disease affecting 2-3% of worldwide population. The extent of skin involvement is variable, ranging from a few localized plaques to generalized involvement. Moderate to severe psoriasis (>10% of body surface area) is frequently associated with psoriatic arthritis and metabolic diseases, like abdominal obesity, diabetes, non-alcoholic fatty liver disease, dyslipidemia, metabolic syndrome, and chronic kidney disease. A common genetic background as well as several acquired risk factors links psoriasis to comorbidities. From a clinical prespective, the understanding of the patients in the context of these comorbidities is very important to ensure that treatment is tailored to meet the individual patient needs. Indeed, some pharmacological treatments may negatively affect cardio-metabolic comorbidities, and have important interactions with drugs that are commonly used to treat them. Non-pharmacological intervention such as diet, smoking cessation, and physical exercise could both improve the response to treatments for psoriasis and reduce the cardiovascular risk.
authors: Section of Dermatology and Venereology, Department of Medicine, University of Verona , Verona , Italy.
authors: Paolo
authors: P
authors: Gisondi
authors: Section of Dermatology and Venereology, Department of Medicine, University of Verona , Verona , Italy.
authors: Arturo
authors: A
authors: Galvan
authors: Section of Rheumatology, University of Verona , Verona , Italy.
authors: Luca
authors: L
authors: Idolazzi
authors: Section of Dermatology and Venereology, Department of Medicine, University of Verona , Verona , Italy.
authors: Giampiero
authors: G
authors: Girolomoni
keywords: biological therapies; comorbidities; conventional therapies; psoriasis
references: Am J Med. 2011 Aug;124(8):775.e1-6
references: 21787906
references: N Engl J Med. 2010 Sep 30;363(14 ):1341-50
references: 20879883
references: Eur J Dermatol. 2011 Nov-Dec;21(6):916-20
references: 21983007
references: J Am Acad Dermatol. 2013 Apr;68(4):654-62
references: 23360868
references: Arch Dermatol Res. 2007 Nov;299(9):461-5
references: 17726611
references: Arch Dermatol. 2010 Jul;146(7):721-6
references: 20644032
references: Nat Genet. 2012 Dec;44(12 ):1341-8
references: 23143594
references: J Eur Acad Dermatol Venereol. 2010 Apr;24 Suppl 2:23-30
references: 20443997
references: Int J Immunopathol Pharmacol. 2007 Oct-Dec;20(4):731-6
references: 18179745
references: Dermatol Ther. 2011 Jul-Aug;24(4):446-51
references: 21910803
references: J Invest Dermatol. 2013 Mar;133(3):836-9
references: 23190900
references: Nutr Diabetes. 2012 Dec 03;2:e54
references: 23208415
references: BMJ. 2013 Oct 15;347:f5961
references: 24129480
references: Br J Dermatol. 2013 Apr;168(4):749-55
references: 23110708
references: Clin Pharmacol Ther. 2006 Dec;80(6):565-81
references: 17178259
references: Am J Clin Dermatol. 2014 Apr;15(2):129-35
references: 24464933
references: G Ital Dermatol Venereol. 2013 Jun;148(3):243-8
references: 23670060
references: Nature. 2007 Feb 22;445(7130):866-73
references: 17314973
references: Br J Dermatol. 2014 Mar;170(3):634-42
references: 24641585
references: J Drugs Dermatol. 2012 Oct;11(10):1210-7
references: 23134986
references: Br J Dermatol. 2015 Feb;172(2):428-36
references: 25142556
references: Drugs Aging. 2014 Apr;31(4):233-8
references: 24554398
references: J Clin Endocrinol Metab. 2013 Feb;98(2):483-95
references: 23293330
references: Br J Dermatol. 2007 Jul;157(1):68-73
references: 17553036
references: J Gastroenterol. 2013 Jul;48(7):839-46
references: 23065020
references: J Eur Acad Dermatol Venereol. 2015 Mar;29(3):515-20
references: 25132013
references: Arthritis Res Ther. 2012 Jun 12;14(3):R141
references: 22691241
references: Br J Dermatol. 2013 Oct;169(4):783-93
references: 23772556
references: J Hepatol. 2007 Jun;46(6):1111-8
references: 17399848
references: J Am Heart Assoc. 2013 Apr 04;2(2):e000062
references: 23557749
references: Am J Clin Nutr. 2008 Nov;88(5):1242-7
references: 18996858
references: J Invest Dermatol. 2013 Oct;133(10):2340-6
references: 23528816
references: J Invest Dermatol. 2010 Jul;130(7):1785-96
references: 20445552
references: J Am Acad Dermatol. 2013 May;68(5):863-5
references: 23602173
references: J Eur Acad Dermatol Venereol. 2013 Jan;27(1):e30-41
references: 22313340
references: J Invest Dermatol. 2010 May;130(5):1213-26
references: 19812592
references: JAMA Dermatol. 2013 Feb;149(2):166-76
references: 23560297
references: J Am Acad Dermatol. 1981 May;4(5):561-6
references: 7240463
references: Arch Dermatol. 2012 Sep;148(9):1089-91
references: 22986877
references: JAMA. 2011 Jun 22;305(24):2525-31
references: 21693740
references: Br J Dermatol. 2013 May;168(5):1124-7
references: 23320916
references: JAMA Dermatol. 2014 Aug;150(8):856-62
references: 24964792
references: J Am Acad Dermatol. 2014 Mar;70(3):517-24
references: 24373781
references: J Eur Acad Dermatol Venereol. 2008 Mar;22(3):341-4
references: 18005022
references: Arch Intern Med. 2007 Aug 13-27;167(15):1670-5
references: 17698691
references: J Am Acad Dermatol. 1986 Nov;15(5 Pt 1):1007-22
references: 2878015
references: JAMA Dermatol. 2013 Jul;149(7):795-801
references: 23752669
references: N Engl J Med. 2009 Jul 30;361(5):496-509
references: 19641206
references: Actas Dermosifiliogr. 2009 Dec;100 Suppl 2:14-21
references: 20096157
references: J Hepatol. 2009 Oct;51(4):758-64
references: 19560226
references: J Invest Dermatol. 2012 Sep;132(9):2206-14
references: 22513786