The American Journal of Medicine
Volume 121, Issue 5 , Pages 360-365, May 2008

Psoriasis and Vascular Disease: An Unsolved Mystery

  • Michael L. Shelling, BS

      Affiliations

    • Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fla
  • ,
  • Daniel G. Federman, MD

      Affiliations

    • Department of Medicine, Veterans Administration Medical Center, Department of Internal Medicine, Yale University School of Medicine, West Haven, Conn.
  • ,
  • Srdjan Prodanovich, MD

      Affiliations

    • Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fla
  • ,
  • Robert S. Kirsner, MD, PhD

      Affiliations

    • Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fla
    • Department of Epidemiology and Public Healing, University of Miami Miller School of Medicine, Miami, Fla
    • Corresponding Author InformationRequests for reprints should be addressed to Robert S. Kirsner, MD, PhD, Department of Dermatology, University of Miami, PO Box 016250 (R250), Miami, Florida 33101.

Abstract 

Psoriasis is an immune disease most commonly recognized for its skin and joint manifestations. These produce significant physical, social, and psychological distress in affected patients and resultant reductions in their quality of life. As expected, these concerns are vital in providing symptomatic improvement and in selecting an individualized therapy. Yet, the approach in management of these patients is likely to change given the growing body of evidence linking psoriasis and vascular disease. Stemming from an anecdotally described relationship, the association between psoriasis and vascular disease has become a focus of current research to further elucidate the pathophysiology underlying and connecting these two diseases. This article includes a review of the classical cardiovascular risk factors, the atherothrombotic markers, and the environmental stressors associated with psoriasis, as well as a critical review of the observed vascular diseases, the proposed mechanism of atherosclerosis, and the benefits of treatment of psoriasis.

Keywords: Atherosclerosis, Cardiovascular risk factors, Coronary artery disease, Myocardial infarction, Psoriasis, Systemic inflammation

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PII: S0002-9343(08)00064-8

doi:10.1016/j.amjmed.2008.01.025

The American Journal of Medicine
Volume 121, Issue 5 , Pages 360-365, May 2008