From Psoriasis to Plaque: Why Cardiovascular Risk Belongs in Every Dermatology Visit
At the 2026 Masterclasses in Dermatology Annual Meeting, Brittany Weber, MD, PhD, delivered a compelling session reframing psoriasis and psoriatic arthritis as cardiovascular disease (CVD) risk enhancers.
Dr Weber opened with a case of a 61-year-old man with psoriatic arthritis and chest discomfort. Despite a previously “normal” LDL-C of 102 mg/dL in 2010, low HDL, high triglycerides, and later a 10-year atherosclerotic CVD (ACVD) risk of 14%, advanced imaging ultimately revealed severe multivessel coronary disease requiring coronary artery bypass grafting. His hsCRP was elevated at 11.0, underscoring the inflammatory burden.
The case highlighted a key concept: “Inflammation and ASCVD” are intertwined. Psoriasis and psoriatic arthritis are now recognized as cardiovascular “risk enhancers,” warranting more aggressive management of traditional risk factors.
Dr Weber reviewed the historical arc of atherosclerosis research—from Virchow’s 1858 description of inflammatory infiltrates to modern understanding of endothelial activation and immune-mediated plaque progression. Inflammatory skin disease intersects with cardiology and immunology, giving rise to the emerging subspecialty of cardio-dermatology.
Cardiovascular manifestations in immune-mediated inflammatory disease are diverse, including accelerated atherosclerosis, coronary microvascular dysfunction, vasospasm, spontaneous coronary artery dissection, pericarditis, myocarditis, arrhythmias, and hydroxychloroquine-induced cardiomyopathy.
Traditional cardiovascular risk factors are elevated in psoriasis, with a strong propensity for dyslipidemia and increasing cardiometabolic risk with greater disease severity. Yet prevention gaps remain. In a Western Denmark registry cohort, plaque prevalence was approximately 75% despite an overall low estimated 10-year ASCVD risk. Among those with coronary plaque, statin prescription rates within 1-year post-coronary computed tomography angiography (CTA) were suboptimal, highlighting missed opportunities for intervention.
Multimodality imaging, including coronary CTA, coronary artery calcium (CAC) scoring, stress positron emission tomography, cardiac magnetic resonance imaging, and echocardiography, can refine risk stratification. Innovative approaches such as CAC-AI applied to prior non-cardiac chest CT scans may identify untreated calcification already visible in the medical record.
Dr Weber emphasized that even small differences in LDL-C reduction can meaningfully alter long-term risk trajectories. Biologic therapies may influence cardiometabolic pathways, but “not all biologics are necessarily equal,” and adverse cardiovascular effects must be considered.
She closed with a couple of questions to be asked for the future: “How, when, and what to screen to identify CVD risk among patients with psoriasis? How to incorporate innovative solutions for addressing cardiometabolic comorbidities for the patients at highest risk within a dermatology clinic? Among special populations, how does imaging play a role in the collaborative care model among multidisciplinary specialties?”
For patients with psoriasis and psoriatic arthritis, dermatologists are not just skin specialists, they are frontline partners in cardiovascular prevention.
For more meeting coverage, visit the Masterclasses in Dermatology newsroom.
Reference
Weber B. From skin plaque to coronary artery plaque: cardiovascular risk and prevention in psoriatic disease. Presented at: Masterclasses in Dermatology; February 19–22, 2026; Sarasota, FL.
