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To the Editor: Psoriasis is considered an immune-mediated inflammatory disease, such as rheumatoid arthritis or Crohn disease. Dr Gelfand and colleagues¹ found psoriasis to be an independent risk factor for MI. This is consistent with similar findings in other immune-mediated inflammatory diseases, such as rheumatoid arthritis,² and supports the systemic nature of the underlying inflammation. Atherosclerosis is regarded as an inflammatory process as well.³ The cascade of events that ultimately results in formation of atherosclerotic plaques begins with infiltration and retention of low-density lipoprotein and activation of endothelial cells. Platelets are the first blood cells to arrive at the scene, likely contributing to further endothelial activation and subsequent formation of an inflammatory cell infiltrate in the forming plaque.⁴

The notions of a crucial role of platelets in the formation of atherosclerotic plaques and psoriasis as a systemic inflammatory disease resulting in higher cardiovascular morbidity are supported by the finding that . . . [Full Text of this Article]

Ralf J. Ludwig, MD
r.ludwig@em.uni-frankfurt.de

Wolf-Henning Boehncke, MD
Department of Dermatology
Clinic of the Johann Wolfgang Goethe University
Frankfurt am Main, Germany