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Psoriasis Depression — SCE Dermatology MCQ

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HardPsychodermatologyPsoriasis DepressionSCE Dermatology

A 42-year-old is starting methotrexate for severe plaque psoriasis after phototherapy failure. Which cardiovascular assessment schedule is recommended by NICE for this severity group?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Assess cardiovascular risk now, then every five years or sooner when indicated

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

A is correct. NICE defines severe psoriasis for this purpose as disease requiring phototherapy, systemic treatment or hospital admission and recommends cardiovascular risk assessment at presentation, then every five years or sooner when indicated. The assessment uses a validated risk approach with management of modifiable factors. It is not deferred by treatment duration, does not mandate annual coronary imaging, and is not contingent on psoriatic arthritis. Waiting until age 60 misses the recognised excess cardiometabolic burden associated with severe inflammatory disease.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations