Back pain and radiating pain to the legs are the most common symptoms encountered in routine neurosurgical practice and usually originates from neurogenic causes including spinal stenosis. The clinial symptoms are often confused with symptoms of peripheral …

This is a case report linking yesterday’s posts on Spinal Stenosis to today’s on Psoriasis. It’s a reminder to doctors to consider Abdominal Aortic Aneurysm (AAA) as a differential to Spinal Stenosis especially in elderly patients presenting with lower back pain and leg claudication symptoms (pain, numbness, weakness). Both conditions can co-exist.

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Of all the reported associations with Psoriasis and/or Psoriatic Arthritis, the most important is with the Metabolic Syndrome (obesity, hypertension, dyslipidaemia, diabetes mellitus, gout, cardiovascular disease). This latest metaanalysis of various earlier studies puts the link quite beyond doubt, especially in those with more severe Psoriasis.

Psoriasis and Metabolic Syndrome


This review from 2008 already suggested that the underlying pathophysiology linking Psoriasis with the Metabolic Syndrome is Inflammation:

Psoriasis and Metabolic Disease

The broad literature linking psoriasis to metabolic disorders has led to changes in standard of care recommendations for patients with psoriasis.
The Inflammation theme is recapitulated and explored further in this more recent 2015 article:

Links and risks associated with psoriasis and metabolic syndrome

Links and risks associated with psoriasis and metabolic syndrome Aikaterini I Liakou, Christos C Zouboulis Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Centre, Dessau, Germany Introduction: Psoriasis has long been considered a systemic inflammatory disease. Lat…|By Dove Press

There have been several reports of psoriasis being linked to chronic renal disease in the literature. Another population-based study has also found a link between severe psoriasis and kidney disease.

Possible mechanisms for this association include hyperuricaemia and atheromatous renal arterial disease.

It is believed that psoriasis is a chronic systemic inflammatory disease. Obstructive sleep apnea…

The obvious link between Psoriasis and Obstructive Sleep Apnoea is through the Metabolic Syndrome: obesity; not so much as one condition causing the other.
Another study posted some time back drew the link between Gout and Sleep Apnoea.…/22/sleep-apnea-is-tied-to-gout/…
Here, it is difficult to explain how one may cause the other. Again, the association may be through the Metabolic Syndrome, Obesity and Inflammation.

Does Psoriasis Increase Risk of Abdominal Aneurysm?

Danish researchers studied a cohort of 59,423 mild psoriasis and 11,566 severe psoriasis patients over a 14 year period, and found 240 and 50 cases of abdominal aortic aneurysms (AAA), repectively. (Citation source

I’ll wrap up today’s posts on Psoriasis associations with what I began with: Abdominal Aorta Aneurysm. The mechanism of the link is plausibly accelerated atherosclerosis, through the inflammatory Metabolic Syndrome.