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Psoriasis CV Risk — SCE Dermatology MCQ

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ModerateInflammatory DermatosesPsoriasis CV RiskSCE Dermatology

A 40-year-old woman with psoriasis has developed metabolic syndrome. She has central obesity, hypertension, dyslipidaemia, and insulin resistance. What is the approximate relative risk of cardiovascular mortality in severe psoriasis compared to the general population?

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Correct answer: D — Approximately 1.5-2× increased relative risk of cardiovascular mortality in severe psoriasis, similar to diabetes as a cardiovascular risk factor

Severe psoriasis is associated with approximately 1.5-2× increased relative risk of major adverse cardiovascular events (MACE) and cardiovascular mortality compared to the general population. Some studies equate the cardiovascular risk conferred by severe psoriasis to that of diabetes mellitus — it is now considered an independent cardiovascular risk factor. The mechanism involves shared inflammatory pathways (TNF-alpha, IL-6, IL-17 driving atherosclerosis), metabolic syndrome components (obesity, insulin resistance, dyslipidaemia all more prevalent in psoriasis), and shared genetic susceptibility loci. This evidence underpins the rationale for comprehensive cardiovascular risk assessment and management as part of holistic psoriasis care per BAD guidelines.

Reference: BAD 2020 Psoriasis Comorbidities; NICE CG153