Is psoriasis a dependent cardiovascular risk factor?

Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of the Dutch population. It has been hypothesized that chronic inflammation occurring in psoriasis patients is more than skin deep, resulting in increased cardiovascular risk. Some observational studies have confirmed this association, although increased cardiovascular risk may also be explained by an increased prevalence of unhealthy life-style factors, systemic medication, the presence of psoriatic arthritis and detection bias. Based on the currently available evidence, we note that the current studies are insufficient to prove that psoriasis has a direct and independent effect on cardiovascular risk. Therefore, suggestions to change the cardiovascular screening and care of psoriasis patients seem to be a step too far. This hypothesis must first be investigated in specifically designed cohort studies or randomized controlled trials.