Metabolic Comorbidities and Cardiovascular Disease in Pediatric Psoriasis: A Narrative Review

Marani, Andrea; Rizzetto, Giulio; Radi, Giulia; Molinelli, Elisa; Capodaglio, Irene; Offidani, Annamaria; Simonetti, Oriana

doi:10.3390/healthcare10071190

Cited by 10 publications

(11 citation statements)

References 29 publications

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“…Pediatric patients with AD are at a higher risk to develop metabolic comorbidities, such as obesity, arterial hypertension, and dyslipidaemia. These disorders are usually underestimated, and are associated with long term sequelae and an increased risk of cardiovascular event, which may occur also later, in adult age, as demonstrated in patients with psoriasis or lichen planus [ 50 , 53 , 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review

Simoni

Rizzetto

Molinelli

et al. 2022

Life

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Atopic dermatitis (AD) is an itchy dermatitis with multifactorial aetiology, chronic-recurrent course, and typical distribution of lesions according to the age, affecting the 10–20% of pediatric population. Patients with AD, including children, suffer from many metabolic comorbidities, including metabolic syndrome, being overweight, obesity, dyslipidaemia, and arterial hypertension, all of which had a prevalence that was demonstrated to be higher than in healthy patients. The association between AD and metabolic comorbidities is multifactorial and involves the deregulation of immune system. In fact, hypertrophic adipose tissue produces soluble adipokines involved in inflammation and immunity, which stimulate the production of pro-inflammatory cytokines, responsible for a chronic low-grade inflammatory state and a higher predisposition to hypersensitivity reactions. Especially in pediatric population with AD, these metabolic disorders are usually underestimated and are associated with long term sequelae and an increased risk of a cardiovascular event, which may also occur later in adult age. Therefore, metabolic comorbidities should be carefully evaluated and early treated in children with AD, to minimize the long-term risk of cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review

Simoni

Rizzetto

Molinelli

et al. 2022

Life

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“…Die Betrachtung der Psoriasis als Systemerkrankung gründet sich auf die Beobachtung, dass zumindest bei Patienten mit mittelschwerer und schwerer Psoriasis proinflammatorische Zytokine nicht nur in der Haut, sondern auch im peripheren Blut erhöht sind und hierdurch der Weg für zahlreiche Komorbiditäten gebahnt wird. Von besonderer Bedeutung im Kindes- und Jugendalter ist die Adipositas, die bereits in dieser frühen Lebensphase nicht nur die Wahrscheinlichkeit der Manifestation einer Psoriasis erhöht, sondern deren Ausprägung auch mit einer schweren Form der Psoriasis korreliert ist [ 13 ].…”

Section: Komorbiditätenunclassified

Psoriasis in children and adolescents

Hamm

Höger

2023

Dermatologie

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Die Psoriasis wird heute als multifaktorielle, entzündliche, immunmediierte Systemerkrankung mit vorrangiger Manifestation am Hautorgan aufgefasst. In etwa einem Drittel der Fälle beginnt sie bereits im Kindes- und Jugendalter und geht oft mit einer deutlichen Beeinträchtigung der Lebensqualität Betroffener und ihrer Eltern einher. Neben der genetischen Disposition sind Triggerfaktoren wie Streptokokkeninfektionen maßgeblich an der Manifestation und an Exazerbationen beteiligt. Auch die bereits in dieser Altersgruppe nachteilige Rolle von Komorbiditäten, allen voran die Adipositas, wurde inzwischen gut belegt. Die Behandlungsmöglichkeiten haben sich durch die Zulassung von nunmehr 5 Biologika im Kindesalter erheblich verbessert, werden aber noch unzureichend genutzt. Der vorliegende Beitrag gibt einen kurzen Überblick über den heutigen Wissensstand und die Empfehlungen der aktualisierten deutschen Leitlinie. Neben den häufigen Typen werden auch ungewöhnlichere Erscheinungsformen wie die pustulöse, die ekzematisierte und die durch TNF(Tumornekrosefaktor)-α-Inhibitoren induzierte „paradoxe“ Psoriasis thematisiert.

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“…Patients with moderate-to-severe psoriasis show subclinical inflammation in the liver, joints, and tendons, in addition to significantly increased global arterial and subcutaneous inflammation [ 6 , 7 , 8 , 9 ]. In fact, systemic elevations in plasma levels of cytokines promote chronic subclinical inflammation associated with arthritis, cardiovascular comorbidities, and metabolic syndromes, such as obesity, dyslipidemia, diabetes, and atherosclerosis [ 10 ]. These associations have been also shown in psoriatic children.…”

Section: Introductionmentioning

confidence: 99%

The Role of Diet in Children with Psoriasis: Emerging Evidence and Current Issues

et al. 2023

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Psoriasis is an immune-mediated inflammatory systemic disease with skin tropism and chronic relapsing course; it is associated with an increased cardiovascular risk and with many metabolic comorbidities, emerging during childhood in 22–33% of cases. Diet influences the presentation and the clinical course of inflammatory diseases, including psoriasis; in particular, it was shown that a Mediterranean, gluten-free, or low-calorie diet may positively affect disease control in adult patients with psoriasis and adequate pharmacological therapy. These three dietary regimens may play a role also in children with psoriasis. It has been demonstrated that pediatric psoriasis is associated with psychological stress, celiac disease, and obesity, which may be positively influenced by these dietary regimens, respectively. Therefore, the expertise of multiple health figures (gastroenterologists, nutritionists, pediatricians, dermatologists) is required to plan a tailor-made dietary strategy, ensuring good growth, through an adequate intake of essential micro- and macronutrients and, at the same time, impacting the pro-inflammatory biochemical profile and on the associated cardiovascular risk of psoriasis disease.

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Metabolic Comorbidities and Cardiovascular Disease in Pediatric Psoriasis: A Narrative Review

Cited by 10 publications

References 29 publications

Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review

Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review

Psoriasis in children and adolescents

The Role of Diet in Children with Psoriasis: Emerging Evidence and Current Issues

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