Psoriatic march: A view from pathophysiology to cardiovascular risk

Abstract

Psoriasis is a disease that is not limited to skin involvement, the importance of systemic compromise is recognized more than ever, especially because of the associated comorbidities, which are explained by the marked chronic systemic inflammatory response mediated by pro-inflammatory cytokines (mainly TNF-α, IL23, IL 17), which play an important role in the induction of insulin resistance, endothelial dysfunction, accelerated atherosclerosis and the increased risk of cardio-cerebrovascular events. The relationship with these outcomes has been demonstrated and hence the concept of psoriatic march, a term that is gaining increasing importance aimed at maintaining and reinforcing the approach to a skin disease with systemic compromise, associated morbidity and mortality that can be preventable and manageable. The pathophysiological mechanisms that explain these phenomena are variable, however, new concepts have been identified, which have made it possible to improve the current approach to the disease and thus establish mechanisms to reduce cardiovascular risk in patients with psoriasis.