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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
REVIEWS ADVANCES IN PSORIASIS
Giornale Italiano di Dermatologia e Venereologia 2007 October;142(5):513-8
Psoriasis comorbidities reflect distinct mechanisms of disease
Department of Dermatology Schleswig-Holstein University Clinics, Kiel, Germany
Epidemiologicial studies recently have shown that psoriasis patients may suffer from associated disorders more frequently than expected. Such comorbidities include psoriatic arthritis, psoriatic pustular diseases, Crohn’s disease, and signs of metabolic syndrome which lead to atherosclerosis with coronary heart disease. Although the disorders represent separate entities they appear to follow overlapping pathogenetic pathways.
Duration and severity play a major role in developing psoriatic arthritis and metabolic dysfunction. Both comorbidities become clinically manifest years after the onset of psoriasis and are more often noted in severe disease. Persistent low grade inflammation with secretion of proinflammatory cytokine e.g. TNF-α favours the development of insulin resistance and metabolic syndrome. In addition biochemical and immunological observations point toward an inflammatory immune mechanism which uses tools of the innate defense armentarium.