Cause-specific mortality in patients with severe psoriasis

Abstract

Conflicts of interest S.R.F. has received research, speaking and/or consulting support from Abbott, Amgen, Astellas, Centocor, Galderma, GSK/Stiefel, and National Biological Corporation. Psoriasis is a complex, immune‐mediated condition with broad effects on patients’ lives. The increased risks of serious comorbidities that have been identified in patients with psoriasis add to the complexity.1 Psoriasis management involves more than just making the diagnosis and prescribing an ointment. Recognition of the broad effects of psoriasis on patients’ quality of life necessitates addressing the psychosocial issues.2 Patients may feel untouchable and isolated; palpating the lesions is an important component of the treatment process that can help heal psychological scars. It is also critically important that dermatologists project to patients a caring attitude; patients’ perceptions of their doctors’ caring attitude largely determines patient satisfaction and, most likely, adherence to recommended treatment.3 Comprehensive management should also include an assessment of joint symptoms – joint pain, joint stiffness and back pain – that may indicate the presence of psoriatic arthritis.4 The recognition of a higher risk of cardiovascular disease and malignancy should encourage queries for and mitigation of other risk factors. The risks should be put into appropriate perspective for patients. Patients hearing there is a threefold increased risk of a lymphoma or myocardial infarction may be terrified.1, 5–7 They should be informed that if their baseline risk is low, a threefold increased risk may not mean much.