Kristine Kucera, PA-C, MPAS, DHS
A growing body of evidence has found that inflammatory skin diseases (ISDs) are associated with an increased risk for cardiovascular comorbidities. Patients with psoriasis have a documented increased for certain cardiovascular disease (CVD) and now evidence suggest that patients with atopic dermatitis may also have increased risks for co-morbid risk cardiovascular disease. Interestingly, a recent study shows that patients with rosacea and alopecia areata may experience similar risks. In fact, the odds ratio for CVD among individuals with rosacea is slightly higher than that among individuals with psoriasis.
Inflammatory skin diseases are driven by elevated levels of inflammatory and pro-inflammatory cytokines that result in systemic inflammation, particularly in patients that have moderate to severe disease. The table below shows the study results and reminds us we need to do thorough medical history on our patients even when being evaluated in the dermatology setting. Because the inflammation is more than skin deep! Sometimes patients hear about studies like this and become alarmed. We can counsel patients that while there appears to be an increased risk associated with inflammatory skin diseases, we believe that habits like exercise and following a healthy diet can modify the risk. There is also early evidence to suggest that effective systemic treatment of moderate to severe psoriasis, for example, may reduce CVD risks.
Kristine Kucera, PA-C, MPAS, DHS, is Assistant Clinical Professor, University of Texas Southwestern, Medical Center PA Program, Dallas, TX. She is a member of the DEF Advisory Council.