Comorbidities classically associated with psoriasis are psoriatic arthritis (PsA), Crohn’s disease (CD), psychological/psychiatric disorders (DPP) and uveitis. MS comprises a group of risk factors, including central obesity, dyslipidemia, hypertension and insulin resistance. 46. Rapp SR, Feldman SR, Exum ML, Fleischer AB, Jr, Reboussin DM. Patients with severe psoriasis were found to have a 5-year shorter life expectancy, with cardiovascular disease contributing significantly to this discrepancy. It is believed that 73 of psoriasis patients have at least one comorbidity. While there is still controversy, many studies already point to a possible bone involvement in patients with psoriasis, especially in the male group, generally less affected by osteoporosis. Borman (2008) also found no significant difference in BMD of psoriasis patients with and without arthritis, although patients with psoriatic arthritis with longer duration of joint disease have high risk of osteoporosis.
In medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The comorbidities were not simplified as an index because each comorbidity affected outcomes (length of hospital stay, hospital changes, and mortality) differently among different patients groups. Although the term has recently become very fashionable in psychiatry, its use to indicate the concomitance of two or more psychiatric diagnoses is said to be incorrect because in most cases it is unclear whether the concomitant diagnoses actually reflect the presence of distinct clinical entities or refer to multiple manifestations of a single clinical entity. Important comorbidities are psoriatic arthritis, metabolic syndrome, Crohn’s disease, depression, and cancer. Psoriatic patients had a 4-fold increased risk of type 2 diabetes, 3-fold risk of myocardial infarction and life expectancy shortened by 4 years compared to healthy controls. NAFLD patients in the psoriasis group were more likely to have metabolic syndrome and diabetes than those with psoriasis alone. Because of the burden of disease and the associated comorbidities, early diagnosis and management in children are essential. Although pediatric psoriasis is not uncommon, limited epidemiology data are available to date. Chiam et al. compared a Dutch and Singaporean group of children with psoriasis and reported that more Dutch children than Singaporean children had a first- or second-degree family member with psoriasis (73. Found calcipotriol/betamethasone dipropionate gel applied once daily for 8 weeks in adolescents (aged 12 17 years) with moderate to very severe plaque psoriasis to be well tolerated and effective.
Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and psoriasis (PsO) are at increased risk of comorbidities such as cardiovascular diseases (CVD; likely related to accelerated atherosclerosis and systemic inflammation), osteoporosis, depression, infections, and cancer1,2. The Canadian DR Comorbidity Initiative group consisted of a steering committee, a bibliographic team, and an expert committee. This patient subgroup has a strong need of sufficient treatment not only for their severe skin symptoms, but also for preventing the possible development of comorbidities and their long-term complications. Psoriasis is a chronic scaling and inflammatory skin disease that can affect patients’ quality of life and daily functioning.
Comorbidities in Pso include psoriatic arthritis (PsA), reduced quality of life, malignancy, depression, but also a constellation of associated conditions that enhance the cardiovascular (CV) risk. Cutaneous lesions are characterized by very well circumscribed scaling papules and plaques that are typically distributed symmetrically on the knees, elbows, scalp, genitals, and trunk (1). In addition, this analysis did not observe an increased risk of CV mortality in patients with Pso or PsA. This study found that the prevalence of MetS was higher in the PsA group (36.5 vs. Psoriatic erythroderma is not substantially different from erythroderma by other causes. A recent study, evaluating the association with comorbidities in psoriasis patients in Italy, showed that, from a total sample of 511, 532 individuals, overall patients had more selected comorbidities compared to healthy controls, in particular chronic ischemic heart disease, obesity, diabetes mellitus, bronchitis, cardiac valve abnormalities, dermatomycosis, benign mammary dysplasias, disorders of penis, disorders of external ear, inflammation of eyelids, and contact dermatitis. (e.g., cardiac diseases, diabetes) between psoriatic and control groups, except for high blood pressure that was more prevalent in psoriatic patients 28 31. Not all kids with psoriasis are at risk of metabolic or cardiovascular disease. 2005 Nov-Dec;46(6):556-64. Assessment by different cardiovascular risk scores. Patients with PsA attending the Psoriatic Arthritis Clinic at the Toronto Western Hospital have been enrolled in a longitudinal observational cohort since 1978. The Functional Comorbidity Index (FCI) is a summary measure of an 18-item list of diagnoses 21. No significant difference in overall QoL between these two groups was found. Screening for these comorbidities in psoriasis patients is essential. 24 26 Social interplay between the patient and society is very complex and multifaceted24; it is not unidirectional and leads to initiation of many coping mechanisms, which include anticipation of discrimination and fear of social rejection. Therefore, patients with psoriasis are likely to undergo different treatments for long periods of time. With the recent introduction of highly efficacious biologic therapies, patients can achieve very good and prolonged responses. Therefore, it is crucial to develop strategies to improve adherence in order to achieve better outcomes, prevent flares, control the comorbidities associated with psoriasis, and improve the overall quality of life (QoL) of patients with psoriasis. Primary nonadherence refers to not redeeming prescriptions and not starting a treatment, whereas secondary nonadherence refers to not using the medications correctly.