Research presented at the Fall Clinical Dermatology 2024 and published in the literature highlights the extensive impact of comorbidities in psoriasis.
The Fall Clinical Dermatology Conference 2024 featured several sessions on psoriasis-related comorbidities. Presenters examined specific comorbidities in patients with psoriasis, including obesity and cardiovascular disease, and how treatment of the underlying skin disease can influence the development of comorbidities.
Physician’s Weekly has compiled a list of highlights from the Fall Clinical Dermatology Conference 2024 and other recent research that discussed the impact of comorbidities in patients with psoriasis.
1. “Provocative Thinking” About a Psoriasis Cure
In a commentary published in the Journal of Investigative Dermatology, Joel M. Gelfand, MD, examined recent advances in psoriasis care and research, including what he called “provocative thinking” about a cure for psoriasis by 2035. Dr. Gelfand also noted that psoriasis has become recognized as a systemic disease.
However, advances beyond the skin manifestations of psoriatic disease, including the association with cardiometabolic dysfunction, have not progressed at the same speed, he noted, despite “intense efforts” to examine these associations. To address these gaps, Dr. Gelfand called for “a paradigm shift in how clinical research is executed in psoriasis.”
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2. Psoriasis & Latent Autoimmune Diabetes in Adults
At the Fall Clinical Dermatology Conference 2024, presentations on psoriasis discussed new treatment options, the impact of comorbidities, and advancing patient-centered care.
A separate study unrelated to the meeting that was published in Diabetologia focused on the risk for one of these comorbidities—latent autoimmune diabetes in adults (LADA)—among patients with autoimmune conditions, including psoriasis. Rates of any concomitant autoimmune disease were 21.7% in the control group, 33.8% in patients with LADA, and 25.8% in patients with T2D. The most prevalent autoimmune diseases were thyroid dysfunction, psoriasis, and rheumatoid arthritis.
The findings add to the growing knowledge base around psoriasis and diabetes. Another recent study on this topic indicated that insulin resistance might influence the efficacy of psoriasis treatment in patients with both conditions.
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3. Body Surface Area & Cardiovascular Risk
Cardiovascular disease is a well-known comorbidity in patients with psoriasis. Findings published in the Journal of the American Academy of Dermatology indicate that cardiovascular disease risk increases with the amount of body surface area affected by psoriasis. Specific outcomes varied by severity. For example, mild psoriasis increased the risk for supraventricular arrhythmias, moderate psoriasis increased the risk for heart failure and atrial fibrillation, and severe psoriasis increased the risk for valve disorders.
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4. Comorbidity Clusters in Patients With Psoriasis
Many studies have compared comorbidities in patients with psoriasis to the general population and explored risk factors, but few have examined comorbidity clusters in patients with psoriasis.
For a study published in Clinical, Cosmetic, and Investigational Dermatology, researchers examined the multimorbidities of psoriasis in terms of risk factors and clusters. Results showed that 30.5% of people had no comorbidities, 28.8% had one, and 40.7% had multiple comorbidities.
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5. Lymphocytic Esophagitis & Severe Psoriasis
Findings published in Cureus highlight a case report of lymphocytic esophagitis associated with chronic severe psoriasis. The female patient presented with GERD with typical and atypical symptoms, including acid regurgitation and chronic cough, and worsening psoriasis despite treatment. The study authors identified lymphocytic esophagitis based on the histological and immunohistochemical findings.
The patient also had strong membranous PD-L1 expression in certain areas.
Together, the findings support “the immunopathological nature of [lymphocytic esophagitis] and its association with other immune and autoimmune disorders,” researchers wrote.
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