Patients with psoriasis, especially those with severe disease, are at increased risk of arthritis, cardiovascular disease, diabetes, and depression. Psoriasis may also result in functional, psychological, and social morbidity, even in patients with minimal involvement.1 Extracutaneous complications of psoriasis are common and typically manifest 1–2 years after the clinical onset of psoriasis, especially in patients with severe disease. Just as the diagnosis of psoriasis, even with obvious signs, can be missed or delayed by up to 5 years in the UK,2 screening for complications is often not done in up to 60% of patients.3 The identification and management of the various complications associated with psoriasis are important aspects of the overall patient-focused treatment and should form part of routine psoriasis assessment and treatment.1 Primary healthcare providers can screen, diagnose, and manage common comorbidities.3

Psoriasis, affecting up to 3% of the population,2 is a chronic, inflammatory, multisystem disease most readily characterised by its dermatological manifestation as erythematous, scaly plaques. An immune-mediated, polygenetic disease, it is the result of a complex interaction between the innate and adaptive immune systems, in particular inflammatory cytokines such as IL1β and TNFα, IL-23, and IL-17.4 Activated immune cells drive a positive feedback loop that maintains keratinocyte activation. These inflammatory pathways, in conjunction with clinical and environmental risk factors, are theorised to be …