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Psoriasis — SCE Dermatology MCQ

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ModerateDermatopharmacologyPsoriasisSCE Dermatology

A 65-year-old man with widespread plaque psoriasis and type 2 diabetes is being considered for biologic therapy. What cardiovascular comorbidity screening is recommended before starting biologics for psoriasis?

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

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Correct answer: BFasting lipid profile, glucose/HbA1c, blood pressure, BMI, and cardiovascular risk assessment

The correct answer is B, fasting lipid profile, glucose/HbA1c, blood pressure, BMI, and cardiovascular risk assessment. Psoriasis, especially moderate to severe disease, is an independent driver of accelerated atherosclerosis, metabolic syndrome and premature cardiovascular disease through chronic systemic inflammation (shared TNF, IL-17 and IL-23 pathways), so anyone being started on a biologic needs full cardiometabolic screening rather than a single test. This patient's combination of widespread plaque psoriasis and type 2 diabetes is exactly the high-risk phenotype UK guidance targets: baseline weight, blood pressure, fasting lipids and glycaemic control must be captured before biologic initiation, and a formal risk score (QRISK) calculated so risk factors can be optimised and monitored longitudinally. No single imaging or cardiac test substitutes for this multi-parameter metabolic and risk-factor assessment.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions