Disease In Psoriasis Patients Research Articles

Bridging the diagnostic gap: liver function tests and IL-6 as potential early predictors of non-alcoholic fatty liver disease in psoriasis

Background: Psoriasis goes beyond skin, intertwining with body systems, notably connecting to nonalcoholic fatty liver disease (NAFLD). This study aims to explore the predictive potential: liver function tests and IL-6 as early markers for non-alcoholic fatty liver disease in psoriasis patients. Methods: From March to November 2023, a case-control study was performed at the dermatological outpatient clinic of Baquba Teaching Hospital, Iraq. Individuals with confirmed psoriasis and those without underwent comprehensive clinical history and overall health examinations. The diagnosis of non-alcoholic fatty liver disease (NAFLD) was established using the Fatty Liver Index (FLI). Results: Among the 290 participants in this study, 103 with confirmed psoriasis displayed a Fatty Liver Index (FLI) score >60, indicative of non-alcoholic fatty liver disease (NAFLD). The control group, comprising 101 individuals without psoriasis or NAFLD, provided a baseline for comparison. The mean ages were 32.5 ± 16.2 and 31.5 ± 14.3 years for the case and control groups, respectively. Notably, the case group exhibited significantly higher mean ± SD levels of ALT and AST (61 ± 29 vs. 33 ± 17 U/L, p < 0.0001) and (55 ± 27 vs. 25 ± 15 U/L, p < 0.0001), respectively. Moreover, FLI criteria were markedly elevated in the case group (p = 0.0007, p = 0.0005, p < 0.0001, and p < 0.0001, respectively), and IL-6 levels were significantly higher (p = 0.0003). Conclusion: The results proposed that liver function tests and IL-6 could act as early predictors for the detection of non-alcoholic fatty liver disease among individuals grappling with psoriasis.

The Relationship of Serum Trimethylamine N-Oxide Levels with Carotid Intima-Media Thickness and Disease Activity in Psoriasis Patients.

Psoriasis is an inflammatory disease that can cause cardiovascular comorbidities. Some recent studies have indicated that impaired gut microbiota and metabolites may be associated with inflammatory diseases. In this study, the relationship between serum trimethylamine n-oxide (TMAO, a gut bacterial metabolite) level and carotid intima-media thickness (CIMT) and disease severity in psoriasis patients was investigated. Age- and gender-matched 73 patients and 72 healthy controls were included in the study. In both groups serum trimethylamine n-oxide(TMAO), oxidized low-density lipoprotein (ox-LDL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, total cholesterol, high-sensitivity C-reactive protein (hs-CRP), creatinine, aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels were recorded and the carotid intima-media thickness (CIMT) was measured by B-mode ultrasonography by a cardiologist. TMAO, hs-CRP, oxidized-LDL, triglyceride and CIMT levels were statistically higher in the patient group. HDL levels were statistically higher in the control group. There was no significant difference between the two groups in terms of total cholesterol and LDL-C levels. In partial correlation analyzes in the patient group, positive correlations were observed between TMAO and CIMT, LDL-C and total cholesterol levels. Linear regression analysis showed that TMAO levels positively predicted CIMT levels. This study confirmed that psoriasis is a risk factor for the development of cardiovascular disease and that elevated serum TMAO levels in these patients indicate the presence of intestinal dysbiosis. Furthermore, TMAO levels were found to be a predictor of the risk of developing cardiovascular disease in psoriasis patients.

Prediction and verification of the effect of psoriasis on coronary heart disease based on artificial neural network

Background and objectivesPsoriasis is an independent risk factor for coronary heart disease. It is important for predicting the complications of coronary heart disease in patients with psoriasis. MethodsIn this study, related cases were collected from the case system of Qingdao University, and commonly used laboratory indicators were extracted. Artificial neural network (ANN) and logistics regression analysis were used to learn to distinguish psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. We identified independent risk factors for coronary heart disease in psoriasis patients that exacerbate coronary heart disease symptoms in patients with psoriasis. FindingsAnalysis shows that the accuracy of the ANN model was higher than 79%. It was determined that age, chlorinated, phosphorus, magnesium, low-density lipoprotein, triglycerides, high density lipoprotein and total cholesterol are independent risk factors for coronary heart disease in patients with psoriasis. Similarly, gender, age, chlorinated, magnesium, triglycerides, and high density lipoprotein are risk factors that exacerbate coronary heart disease symptoms in patients with psoriasis. InterpretationThe presented approach is a valuable tool for identifying psoriasis patients, coronary heart disease patients, and psoriasis patients with coronary heart disease. It can also serve as a support tool clinicians in the diagnostic process, by providing an outstanding support in the diagnostics prevention of coronary heart disease in psoriasis.

Biological therapy of psoriasis in the era of COVID-19: discussing the risks and benefits

BACKGROUND: The new coronavirus infection COVID-19 in 2020 has spread widely around the world, including the Russian Federation. Risk factors for adverse outcomes of COVID-19, such as obesity, diabetes, chronic heart and kidney diseases, non-alcoholic fatty liver hepatosis, often accompany psoriasis, especially severe. Assessment and reduction of these risks have become an integral task of psoriasis therapy. An important issue was the use of immunosuppressive therapy in patients during the pandemic.
 AIMS: In this article, we tried to analyze the international experience of colleagues with a focus on psoriasis and correlate it with our own experience. To assess the impact of psoriasis, concomitant syndromes and applied biological and non-biological systemic therapy on the risk of infection and the nature of the course of COVID-19.
 MATERIALS AND METHODS: The analysis of available scientific publications on the effect of psoriasis, concomitant comorbidities and the therapy used on the incidence, nature of the course and outcomes of the new coronavirus infection COVID-19 was carried out. Data collection (questionnaire and analysis of available medical documentation on transferred COVID-19 cases and detection of antibodies) and a retrospective analysis of the history of COVID-19 disease in psoriasis patients in the Republic of Crimea who are on dispensary registration and receiving systemic (biological and targeted) therapy (n=146) were performed. The search for articles on the topic was carried out in the PubMed database in English and Russian, published in the period from 2019 to 2021.
 RESULTS: According to available literature data, systemic biological drugs from the group of interleukin inhibitors for the treatment of psoriasis did not worsen the course of COVID-19.
 Established a proactive anti-inflammatory effect for drugs from the group of IL-17 inhibitors.
 According to the latest version 14 of the recommendations for the treatment of COVID from 27.12.2021, the IL-17A inhibitor netakimab is included in the group of drugs of proactive anti-inflammatory therapy. Out of 146 patients with psoriasis receiving biological and targeted therapy, 8 patients underwent acute respiratory infections in 18 months, confirmed COVID-19 was established in 26 cases, antibodies were detected in 54 patients. Out of the patients with pneumonia and COVID-19, hospitalization for biological therapy was not required and only one case of hospitalization for therapy with apremilast (CT 1) was recorded. It should be noted that in the families of patients undergoing biological therapy, there were cases of COVID-19 (CT 23) and even a fatal outcome, however, no clinical manifestations of the disease were observed in our patients, and antibodies were detected during laboratory examination.
 CONCLUSIONS: To date, there is no convincing evidence that drugs for systemic therapy of psoriasis can worsen the course of COVID-19. A proactive anti-inflammatory effect was noted for drugs from the group of IL-17 inhibitors. The existing international and Russian recommendations on the management of patients on biological therapy in the COVID-19 pandemic reflect the current experience and views of the expert community, it is necessary to further accumulate new data and exchange clinical experience along with the evolution of the pandemic. Available vaccines against COVID-19 that are not live may be used with caution during immunosuppressive therapy.

Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management.

PurposeTo review the literature on guidance on the follow-up of psoriasis and its comorbidities and to provide practical recommendations.Patients and MethodsA PubMed search was conducted using MeSH terms and free text keywords related to “psoriasis”, “obesity”, “hypertension”, “diabetes”, “dyslipidemia”, “metabolic syndrome” and “Psoriatic arthritis”. The search was conducted between September 2021 and January 2022. References of selected articles were scanned to identify additional articles.ResultsRecommendations on the follow-up of hypertension, obesity, dyslipidemia, type 2 diabetes, metabolic syndrome, psoriatic arthritis, non-alcoholic fatty liver disease and inflammatory bowel disease in psoriasis patients were extracted from the included articles. These data are presented in summary tables for both adults and children. A practical and feasible approach for each comorbidity is discussed.ConclusionAwareness among dermatologists for relevant psoriasis-associated comorbidities is crucial. The dermatologist should function as gatekeeper and screen for comorbidities, in order to make timely referrals when indicated.

PSORIASIS AND CARDIOVASCULAR DISEASE: IS IT CORRELATE?

Psoriasis is a common chronic inflammatory disease. This disease can cause a significant reduction in a person's quality of life. Systemic inflammation of psoriasis is thought to play a role in increasing the incidence of cardiovascular disease. Cardiovascular disease in psoriasis patients is a significant economic burden. Therefore, it is important for a doctor to understand and prevent the occurrence of cardiovascular disease in this population. This review aims to review the relationship between psoriasis and the incidence of cardiovascular disease, the underlying mechanisms, and the impact of the treatment of each disease on the other. There are overlapping risk factors for these two conditions. The underlying pathology of these two diseases is inflammation. The inflammation and treatment of one of these diseases might have an impact on the other. Psoriasis and cardiovascular disease are closely related to each other.

Clinical implications of intermittent Ramadan fasting on stable plaque psoriasis: a prospective observational study.

IntroductionPsoriasis is a chronic immune-mediated inflammatory disease. Environmental factors including diet have been supposed to play a role in its pathogenesis. Fasting in Ramadan consists of intermittent fasting in which participating Muslims refrain from eating and drinking from dawn up to sunset.AimTo validate the possible clinical consequences of Ramadan fasting for patients with psoriasis.Material and methodsThe study was conducted in Ramadan 2019. It included patients over 18 years who were diagnosed with stable chronic plaque psoriasis. PASI and BSA scores, body mass index and biochemical tests (including blood lipids, fasting blood glucose) were compared before and after a month of Ramadan fasting.ResultsThe study included 121 psoriasis patients. The mean PASI score was 4.36 ±3.22 at the beginning of the study, which was reduced to 3.51 ±1.26 at the end of the study. The difference was statistically significant (p = 0.001). There was no difference in the change of weight. We found a statistically significant difference in fasting plasma glucose, HDL and triglycerides. Only mild adverse events were noted during the study period.ConclusionsRamadan intermittent fasting has beneficial effects on severity of the disease in psoriasis patients with a reduction in PASI score and no serious health hazards. Thus, Ramadan intermittent fasting could be considered during treatment of psoriasis patients.

Impact of long-term systemic treatment for psoriasis on liver disease in psoriasis patients with coexisting hepatitis B virus infection.

Continuously updated information is helpful for evaluating the safety of long-term systemic drug use in psoriasis patients with concomitant hepatitis B virus (HBV) infection. To investigate the impact of long-term systemic treatment for psoriasis on liver disease in psoriasis patients with HBV infection. Data of patients during 10-year period were recorded and analyzed. Sixty-six patients (46 males and 20 females) with a mean age of 58.5 ± 13.1 years were recruited. Our study estimated that the 5-year cumulative risks of developing cirrhosis and HCC were 30% and 5%, respectively, in patients receiving systemic treatments for psoriasis. Risks of cirrhosis and HCC were not significantly different between systemic and topical treatment groups. Thirty patients were prescribed systemic treatments (acitretin, methotrexate, ciclosporin, and anti-tumor necrosis factors). Three HBsAg+ patients developed viral reactivation (two patients with methotrexate and one patient with ciclosporin). The effects of systemic treatments for psoriasis on liver outcome in patients with coexisting HBV infection are needed to be determined. HBsAg+ patients are more likely to develop viral reactivation during systemic treatment for psoriasis than HBsAg- patients. Monitoring of liver enzymes and HBV DNA every 3 months is recommended during treatment and for 6 to 12 months after drug discontinuation.

Pilot study: immunohistochemistry expressions of vitamin D receptor associated with severity of disease in psoriasis patients.

Psoriasis is a chronic inflammatory skin disorder characterized by keratinocyte hyperproliferation, differentiation abnormalities, and resistance to apoptosis. There are several factors that can affect psoriasis and vitamin D is one of the recently arisen. The role of vitamin D is mediated by vitamin D receptors (VDR) in target cells. VDR is a nuclear hormone that is involved in the antiproliferation and pro-differentiation pathways in keratinocytes. However, until now vitamin D/VDR signaling in psoriasis has not been fully understood. A cross-sectional study that involved 28 skin specimens from psoriasis patients to assess the immunohistochemistry expressions of VDR as well as their association with severity and duration of psoriasis. Statistical analyses were performed using Spearman's correlation coefficients, with P<0.05 was considered statistically significant. In total, 28 specimens from psoriasis patients consisting of 60.7% women and 39.3% men, with mean age 41.28±14.97years, predominantly age group 46-55years (25%), mean duration of disease 6.64±4.26years, and mean Psoriasis Area and Severity Index (PASI) score 19.23±11.30. The immunohistochemistry expressions of VDR were predominantly strong (57.1%) and located in the basal layer (53.6%). There were a significant negative correlation between the expressions of VDR and PASI score (P<0.001, r=-0.719) and between the expressions of VDR and duration of disease in psoriasis (P=0.020, r=-0.438). VDR expressions and severity of psoriasis showed a strong significant negative correlation and also a moderate significant negative correlation between VDR expressions and duration of disease.

The relationship between alexithymia, anxiety, depression, and severity of the disease in psoriasis patients

Aim: It is known that psychological factors are significant in the onset and exacerbation periods of psoriasis. The purpose of this study is to evaluate the levels of anxiety, depression, and alexithymia in psoriasis patients and to determine their relationship with the severity of disease and quality of life.Methods: In this case-control study, 71 patients with psoriasis and 86 healthy people constituted the study and control groups, respectively. The clinical severity of psoriasis was determined by the “Psoriasis Area Severity Index” (PASI). “Dermatological Life Quality Index” (DLQI) form was conducted on the patients, and the “Toronto Alexithymia Scale”, “Beck Depression Scale” and “Beck Anxiety Scale” questionnaires were used for both the patients and the controls.Results: Anxiety and depression scores in psoriasis patients were significantly higher than controls (P=0.029, P=0.003, respectively), but there was no significant difference between alexithymia scores (P=0.158). A positive correlation was found between PASI and alexithymia scores (P=0.004), and between the DLQI score of psoriasis patients and anxiety, depression, alexithymia, and PASI scores (P&lt;0.001, P=0.006, P=0.004, P=0.001, respectively).Conclusion: In our study, anxiety and depression levels were high in psoriasis. As the levels of anxiety, depression, and alexithymia increased, the quality of life deteriorated. Psoriasis patients should be not evaluated dermatologically only, but also be assessed psychologically and directed to the psychiatry outpatient clinic when necessary.

Epicardial Fat: A New Therapeutic Target in Psoriasis.

Psoriasis is a chronic inflammatory disease affecting over 8 million Americans. Importantly, patients with psoriasis are at an increased risk of developing atherosclerosis, coronary artery disease, and myocardial infarctions. Several studies have suggested that psoriasis may be an independent risk factor for cardiovascular disease given their shared inflammatory properties and pathogenic similarities. Epicardial fat is also linked to cardiovascular disease and may be an independent risk factor for atherosclerosis. It has been proposed that measuring epicardial fat tissue may serve as a useful subclinical measure of cardiovascular disease in psoriasis patients. Echocardiography has been increasingly adopted as an accurate, minimally invasive, and cost-effective measure of determining the volume and thickness of epicardial fat. Using echocardiographic measures of epicardial fat thickness as a marker of cardiovascular disease and therapeutic target in psoriasis patients may provide clinicians with a means to better manage and hopefully prevent deleterious downstream effects.

Analyzing the value of an educational program for psoriasis patients: a prospective controlled pilot study

BackgroundPsoriasis is a chronic inflammatory skin disease associated with a reduced life-quality. Severe disease forms put the patients at risk for life-treating cardiovascular events, metabolic, and other immune-mediated disorders. Psoriasis patients are often not sufficiently informed about their condition leading to suboptimal treatment adherence and, consequently, worse patient outcome. We investigated the value of an educational program on knowledge and self-expertise about the disease in psoriasis patients in general and dependent on age and disease duration.MethodsRegular visit psoriasis-patients were asked to participate and choose to receive an additional educational program or not. Participating patients (n = 53) filled out two questionnaires: one at study inclusion and one at the next regular visit or after the absolved educational program. Surveys included disease knowledge assessment and numeric rating scales (0–10) for self-expertise about the disease, therapy adherence, and therapy satisfaction. The Dermatology Life Quality Index (DLQI) was used to investigate the quality of life.All continuous parameters were examined for statistically significant differences by paired t-test or unpaired t-test. Continuous parameters without Gaussian distribution were analyzed with the Wilcoxon matched pairs test or the Mann-Whitney test. For all categorical parameters, Fisher’s exact test was used.ResultsPatients who chose to be educated (n = 24) showed a significant increase in knowledge, self-expertise about the disease and amelioration of general health. No positive short-term effects were seen on the quality of life and therapy adherence. Analyzing the effect of age and disease duration, the educational program led to significant improvement of the emotional well-being in older patients (≥50 years) and with a longer disease duration as well as significant amelioration of the self-expertise about psoriasis in younger patients (< 50 years).ConclusionsPatients who chose to participate in an educational program show a higher gain in knowledge and self-expertise about the psoriatic disease. Educational program thus might have a positive effect on the long-term management of psoriasis. Further long-term studies are needed to provide evidence for the influence educational programs have on outcome, quality of life, and treatment adherence of psoriatic patients.Trial registrationDeutsches Register Klinischer Studien DRKS00017318 (09.10.2019), retrospectively registered.

The incidence rates and risk factors of Parkinson disease in patients with psoriasis: A nationwide population-based cohort study

The association between psoriasis and Parkinson disease has not been established. To determine the incidence rates and risk factors of Parkinson disease in patients with psoriasis. We conducted a nationwide population-based cohort study. The data from patients with psoriasis (N=548,327, ≥20years of age, 53.32% men and 46.68% women) and age- and sex-matched control patients (N=2,741,635) without psoriasis were analyzed in this study. The incidence rates of Parkinson disease per 1000 person-years were 0.673 and 0.768 in the control and psoriasis groups, respectively. The psoriasis group showed a significantly increased risk of developing Parkinson disease (hazard ratio [HR] 1.091, 95% confidence interval [CI] 1.029-1.115). The risk of Parkinson disease was significantly higher among the psoriasis patients who were not receiving systemic therapy (HR 1.093, 95% CI 1.031-1.159) and lower among the psoriasis patients on systemic therapy (HR 1.04, 95% CI 0.806-1.316). The limitations of this study included the retrospective design, patient inclusion solely on the basis of diagnostic codes, and unavailability of data on confounding factors. Systemic anti-inflammatory agents might mitigate the risk of Parkinson disease in psoriasis patients.

Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study.

Psoriasis is known to confer a higher risk of cardiovascular and cerebrovascular diseases. However, very few studies have investigated whether the development of depression in psoriasis patients may further increase this vascular risk. We investigated the risk of ischaemic heart disease and cerebrovascular disease in Taiwanese psoriasis patients with and without depression. A nationwide population-based retrospective cohort study was performed using the National Health Insurance Research Database. We included 604 psoriasis patients with depression, who were matched to 2416 psoriasis patients without depression (1:4 ratio). Relative risks (RR) with 95% confidence intervals (CI) were determined using the Cox proportional hazards regression model, with adjustment for demographic characteristics and comorbidities. Compared with psoriasis patients without depression, psoriasis patients with depression had greater risk of developing incident ischaemic heart disease (19.5% vs. 8.3%, adjusted RR 1.98, 95% CI 1.57-2.49), cerebrovascular disease (15.6% vs. 5.9%, adjusted RR 2.29, 95% CI 1.76-2.98), and either ischaemic heart disease or cerebrovascular disease (28.3% vs. 12.5%, adjusted RR 1.94, 95% CI 1.60-2.35). Subgroup analysis showed that in psoriasis patients with depression, a higher risk of incident ischaemic heart disease or cerebrovascular disease was present in age groups 30-100years, in both males and females, and in both lower and higher income categories. Depression is an independent risk factor for incident ischaemic heart disease and cerebrovascular disease in patients with psoriasis. Therefore, clinicians need to be vigilant for the increased vascular risk in psoriasis patients with depression.

Antagonization of IL-17A Attenuates Skin Inflammation and Vascular Dysfunction in Mouse Models of Psoriasis

Besides skin inflammation, patients with severe psoriasis suffer from an increased risk of cardiovascular mortality. IL-17A plays a central role in the development of psoriasis and might connect skin and vascular disease. The aim of this study was to clarify whether anti-IL-17A therapy could also ameliorate the vascular dysfunction associated with severe psoriasis. We analyzed three murine models with varying severities of psoriasis-like skin disease concerning their vascular function and inflammation: (i) K14-IL-17Aind/+ mice with keratinocyte-specific IL-17A overexpression and an early-onset severe psoriasis-like phenotype; (ii) homozygous CD11c-IL-17Aind/ind and heterozygous CD11c-IL-17Aind/+ mice overexpressing IL-17A in CD11c+ cells, leading to a delayed onset of moderate psoriasis-like skin disease; and (iii) the acute model of imiquimod-induced psoriasis-like skin inflammation. Similar to the severity of skin disease, vascular dysfunction correlated with peripheral IL-17A levels and neutrophil infiltration into the aortic vessel wall. Successful anti-IL-17A treatment of psoriatic skin lesions diminished peripheral oxidative stress levels, proinflammatory cytokines, and vascular inflammation. These data highlight the pivotal role of IL-17A linking the development of skin lesions and vascular disease in psoriasis. Anti-IL-17A therapy might thus represent a useful approach to attenuate and prevent vascular disease in psoriasis patients.

Characteristics and management of coexisting autoimmune bullous disease in psoriasis patients

Characteristics and management of coexisting autoimmune bullous disease in psoriasis patients

124 The risk of liver disease in psoriasis patients: A population-based cohort

124 The risk of liver disease in psoriasis patients: A population-based cohort

Homocysteine plasma levels in psoriasis patients: our experience and review of the literature.

People with psoriasis are at higher cardiovascular risk. Plasma levels of homocysteine over the normal range have been recognized as marker of cardiovascular risk. Psoriasis patients express higher levels of plasma homocysteine than healthy people. Our study aims to investigate the correlation between homocysteinaemia, severity and duration of psoriasis and psoriasis arthritis, and to evaluate the effect of a 12-week administration of a target therapy for psoriasis on homocysteinaemia. Fifty-two psoriasis patients (study group) submitted to different kind of therapy for psoriasis (biological, systemic not biological and topical) and 24 healthy Italian subject (control group) were evaluated for their plasmatic homocysteine levels, both at baseline (T0) and 12 weeks after they a specific therapy for psoriasis. A significant difference between the homocysteinaemia of psoriasis patients (mean 19.71 ± 11.16) and control group (13.90 ± 11.18), P < 0.05 (Fig. 1), was found at baseline (T0). The mean plasma levels of homocysteine were directly correlated with disease severity (P = 0.0401), but not with disease duration (P = 0.6018) or presence of arthritis (P = 0.6221) at baseline. None among the treatments administered to psoriasis patients caused a significant reduction in homocysteinaemia after 12 weeks of treatment. Our results confirm that psoriasis patients with more severe disease, can have hyperhomocysteinaemia, without regard to disease duration or joint involvement. Hyperhomocysteinaemia is not influenced by a target therapy for psoriasis and it is as greater as psoriasis severity. However, limitation of our study is the relatively small number of cases. Homocysteine plasmatic levels should be advisable as a further independent risk factor for cardiovascular disease in psoriasis patients.

Increased subclinical atherosclerosis in patients with chronic plaque psoriasis

Background: Psoriasis is an immune-mediated inflammatory skin condition of unknown aetiology which usually requires life-long treatment. It is regarded a systemic inflammatory disease with a possible increased risk of cardiovascular disease. The aim of this study was to assess carotid intima-media thickness (IMT), plaque prevalence and carotid stenosis as surrogate measures for cardiovascular disease in psoriasis patients and healthy controls. Methods: Sixty-two patients with psoriasis and thirty-one healthy controls were included in the study. All were examined by Colour duplex ultrasound of the carotid arteries to compare carotid IMT values, carotid plaques and carotid stenosis in the two groups. Adjustments were made for traditional cardiovascular risk factors. Results: Patients with psoriasis had increased carotid IMT values compared to the controls: mean ± SD 0.71 ± 0.17 mm vs. 0.59 ± 0.08 mm; p = 0.001. When adjusted for known atherosclerotic risk factors this difference remained significant (p = 0.04). Carotid plaques were also more common (p = 0.03) in patients with psoriasis 13 (21%) compared to controls 1 (3%). There was no difference with regard to the number of carotid stenoses in patients and controls. Conclusion: The results of this study support previous evidence which suggests that psoriasis is associated with an increased risk for atherosclerosis and subsequent cardiovascular disease.

Levels of Physical Activity in Patients with Severe Psoriasis: A Cross-Sectional Questionnaire Study

Psoriasis is a chronic inflammatory disease associated with increased cardiovascular mortality, secondary to the increased prevalence of cardiovascular risk factors and premature atherosclerosis. Physical activity is a vital component in prevention and management of cardiovascular disease. Few studies have examined the level of physical activity in psoriasis patients, using validated questionnaires or other objective assessment tools. The aim of this study was to analyze and compare physical activity undertaken by patients with severe psoriasis and healthy controls, using the International Physical Activity Questionnaire-Short Form (IPAQ-S), a validated instrument for assessing physical activity. Ninety patients with severe plaque-type psoriasis and 160 healthy subjects were enrolled in the present study. Physical activity was evaluated using IPAQ-S. Psoriasis patients had reduced levels of physical activity compared with non-psoriasis patients, regardless of sex or whether the variable was continuous or categorical. The odds ratio for low-level physical activity for psoriasis patients, compared with controls, was 3.42 (95% CI 1.47-7.91), indicating that this severe psoriasis population did not undertake recommended levels of physical activity. Psoriasis patients exhibit decreased levels of physical activity, possibly for both psychological and physiological reasons. The lack of physical activity may contribute to the increased risk of cardiovascular disease in psoriasis patients, in addition to the intrinsic risks related to systemic inflammation and psoriasis-linked comorbidities. Regular physical activity should be encouraged in all psoriasis patients because of its beneficial effects on systemic inflammation and cardiometabolic comorbidities associated with psoriasis.