Vol. 149 - Suppl. 2 to No. 1 GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA 7 class I region of the major histocompatibility locus antigen cluster which harbour the human leukocyte antigen Cw6 and it is associated to early onset pso- riasis. 3 The current understanding of the molecular pathogenesis of psoriasis assigns central importance to the interaction between acquired and innate immu- nity. 4 Chronic plaque psoriasis is the most common form of the disease and is tipically characterised by well delineated red and scaly plaques. 5 The extent of skin involvement is widely variable, ranging from a few localised plaques at extensor sites to generalised involvement. Moderate to severe psoriasis is deined if the body surface involvement is greater than 10%. Patients with psoriasis, like those with other major medical disorders, have a decreased quality of life as well as a reduced employment and income. 6 1 Department of Medicine Section of Dermatology and Venereology University of Verona, Verona, Italy 2 Section of Endocrinology, Diabetes and Metabolism University of Verona, Verona, Italy 3 Unit of Dermatology University Hospital Sant’Orsola Malpighi Bologna, Italy 4 Unit of Dermatology University Hospital Policlinico di Modena Modena, Italy 5 Unit of Dermatology “Guglielmo da Saliceto” Hospital, Piacenza, Italy 6 Unit of Dermatology Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Italy 7 Section of Dermatology Department of Surgical Sciences University of Parma, Parma, Italy G ITAL DERMATOL VENEREOL 2014;149(Suppl. 2 to No. 1):7-11 P. GISONDI 1 , G. TARGHER 2 , F. BARDAZZI 3 , A. CONTI 4 , S. DONELLI 5 V. G. DI LERNIA 6 , S. DI NUZZO 7 , C. LASAGNI 4 , G. GIROLOMONI 1 Pharmacological treatment of moderate-severe psoriasis in patients with cardio-metabolic comorbidities Psoriasis is a chronic inlammatory skin disease affecting 2-3% of worldwide population. The extent of skin involve- ment is variable, ranging from a few localised plaques to generalised involvement. Moderate to severe psoriasis (>10% of body surface area) is frequently associated with psoriatic arthritis and metabolic diseases, like abdominal obesity, dia- betes, nonalcoholic fatty liver disease, dyslipidemia and the metabolic syndrome. A common genetic background links psoriasis to these comorbidities. From a clinical prospective, the understanding of the patients in the context of these co- morbidities is very important to ensure that treatment is tai- lored to meet the individual patient needs as some pharma- cological treatments may negatively affect cardio-metabolic comorbidities, and have important interactions with drugs that are commonly used to treat them. Finally, patients with moderate to severe psoriasis are at increased cardiovascular risk, and need appropriate screening for comorbidities and early, aggressive interventions, such as diet and physical ex- ercise, in order to reduce their global cardio-vascular risk. Key words: Psoriasis - Comorbidities - Biological therapy - Obesity - Diabetes mellitus. P soriasis is an immune-mediated chronic inlam- matory disease affecting approximately 2-3% of Caucasian people. 1 It can occur at any age, although the majority of cases develop before the age of 40 years and it is uncommon in children. 1 Psoriasis is a complex disease with a strong genetic background. 2 So far, about 20 chromosome regions have been proposed to harbour psoriasis susceptibility genes, which affect mostly innate and adaptive immune responses. One locus consistently identiied is the Corresponding author: P. Gisondi, Department of Medicine, Section of Dermatology, University of Verona, piazzale A. Stefani 1, I-37126 Verona, Italy. E-mail: paolo.gisondi@univr.it MINERVA MEDICA COPYRIGHT® This document is protected by international copyright laws. No additional reproduction is authorized. It is permitted for personal use to download and save only one file and print only one copy of this Article. It is not permitted to make additional copies (either sporadically or systematically, either printed or electronic) of the Article for any purpose. It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems, electronic mailing or any other means which may allow access to the Article. The use of all or any part of the Article for any Commercial Use is not permitted. The creation of derivative works from the Article is not permitted. The production of reprints for personal or commercial use is not permitted. It is not permitted to remove, cover, overlay, obscure, block, or change any copyright notices or terms of use which the Publisher may post on the Article. It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher.