Systemic and Vascular Inflammation in Patients With Moderate to Severe Psoriasis as Measured by [18F]-Fluorodeoxyglucose Positron Emission Tomography –Computed Tomography (FDG-PET/CT)

Abstract

Psoriasis is a chronic inflammatory disease affecting 2% to 3% of the adult population.^1,2 It is associated with an inflammatory arthritis (psoriatic arthritis) in about 10% of patients, with much higher frequencies in patients with more extensive skin disease.³ Psoriasis is also associated with increases in markers of inflammation in the skin and blood and increasingly is thought to be a systemic inflammatory disease and risk factor for incident diabetes mellitus, myocardial infarction, stroke, and premature cardiovascular (CV) death.^4-18 The mechanism behind these associated comorbidities, however, remains unknown. It has been widely suggested that a possible common pathway linking psoriasis to metabolic and CV disease is chronic inflammation mediated by T_H17 and T_H1 cells.^19-23 Yet, despite evidence of systemic inflammation in psoriasis, few techniques have been successfully used to identify and quantify locations of inflammation in vivo in these patients. Because traditional markers of systemic inflammation, such as high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate, only modestly correlate with psoriasis severity and do not provide regional information about disease involvement, novel assessments of inflammation in vivo are particularly important in understanding the impact of psoriasis on systemic inflammation and systemic comorbidities.²⁴