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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Dermatology

Advisor

Nancy Reid

Abstract

Psoriasis is a disorder of the skin and joints, affecting 125 million people worldwide. Psoriatic disease accounts for substantial physical and psychological disability, increased work absenteeism, significant socioeconomic burdens, and increased rates of cardiometabolic diseases. The complex immune-mediated responses in psoriasis are regulated by the body’s innate and adaptive immune systems. Shared inflammatory pathways between psoriasis, dyslipidemia, insulin resistance, and atherosclerosis increase the risk of cardiovascular disease (CVD) and major adverse cardiovascular events (MACE) in psoriasis patients. Additionally, psoriasis-associated cardiometabolic comorbidities result in increased health care costs and increased morbidity and mortality. Clinicians must recognize the cardiometabolic comorbidities associated with psoriasis and stratify treatment to minimize further cardiovascular risks in psoriasis patients to limit long-term disability and reduce the prevalence of premature cardiovascular death. This article will review the risks of cardiovascular disease (CVD) associated with psoriasis and aims to determine whether methotrexate or tumor necrosis factor-𝛼 inhibitors produce a more significant risk reduction of CVD and major adverse cardiovascular events (MACE).

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