Psoriasis comorbidities and clinical implications when using biologics

Background Psoriasis is a cutaneous inflammatory disorder with associated comorbidities which can influence treatment options. Biologics are immune‐modifying agents that can improve or worsen pre‐existing psoriasis comorbidities. The risks associated with a particular biologic agent and its effects on a comorbidity can guide treatment decisions and direct further workup to screen for markers of these comorbidities. Methods A literature search was performed to develop treatment recommendations for psoriasis patients in the background of common comorbidities when considering biologic agents. Results Psoriatic arthritis, inflammatory bowel disease, metabolic syndrome, nonalcoholic fatty liver disease, depression, and malignancies are comorbidities associated with psoriasis that can be affected by certain biologic agents. Conclusion Considerations to make when treating a patient with psoriasis include the severity of disease, the presence of comorbidities, and symptomology that can interact with biologic agents.