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QRISK3 Psoriasis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesQRISK3 PsoriasisSCE Dermatology

A 45-year-old man with psoriasis has developed metabolic syndrome. His dermatologist recommends cardiovascular risk assessment using QRISK3. What specific adjustment does QRISK3 make that is relevant to psoriasis?

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

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Correct answer: D — QRISK3 does not include psoriasis as a specific risk factor — however, dermatologists should consider that psoriasis confers additional CV risk not captured by QRISK3 and should manage modifiable risk factors aggressively

QRISK3 (the UK standard cardiovascular risk calculator) does NOT currently include psoriasis as a specific input variable — unlike rheumatoid arthritis, SLE, and CKD which are included as inflammatory/systemic disease risk multipliers. This means QRISK3 may UNDERESTIMATE cardiovascular risk in severe psoriasis patients. Dermatologists should be aware of this limitation and should: (1) ensure all modifiable risk factors captured by QRISK3 (BP, lipids, diabetes, smoking, BMI) are optimised; (2) recognise that the true CV risk in severe psoriasis may be higher than the QRISK3 score suggests; (3) advocate for aggressive primary prevention in high-risk patients. There is ongoing discussion about incorporating psoriasis into future risk calculator versions.

Reference: BAD 2020 Psoriasis Comorbidities; NICE CG181