Once considered to be solely a cutaneous disease, there is now robust evidence that psoriasis is associated with systemic inflammation and a significantly increased risk of cardio vascular disease (CVD). Moderate to severe psoriasis is associated with a higher incidence of cardiovascular risk factors such as diabetes mellitus, obesity, smoking, and the metabolic syndrome [1, 2]. It is now well established that patients with severe psoriasis have an excess mortality compared with the general population [1].

It has yet to be established whether these comorbidities occur as a direct result of the systemic inflammation associated with psoriasis, as a consequence of genetically determined selection, or whether other factors are involved [3]. Some reports have emphasized that psoriasis may be an independent risk factor for myocardial infarction (MI), especially in young individuals with severe psoriasis [2, 4, 5]. Therefore, dermatologists should be vigilant to any risk factors that might aggravate the psoriasis patient’s condition and result in the development of CVD and other disorders. As the intensity of the skin changes indicates not only the severity of psoriasis, but also that of other systemic pathologies, symptoms detected in a psoriasis patient may suggest major changes of multigenic nature. According to Mallbris, et al.[4] psoriasis patients with severe and longstanding skin lesions suffer increased morbidity and mortality from CVD-related events [4, 2].