Psoriasis is a systemic chronic inflammatory disease associated with 
comorbidity. Many epidemiological studies have shown that psoriasis is 
associated with psoriatic arthritis as well as cardiovascular and metabolic 
diseases. Furthermore, obesity and psychological diseases such as depression and 
anxiety disorders are linked with psoriasis and play a central role in its 
management. The association of psoriasis and its comorbidity can be partly 
explained by genetic and pathophysiological mechanisms. Approximately 
40 psoriasis susceptibility loci have been described with the majority linked to 
the innate and adaptive immune system. In some associated diseases, such as 
psoriatic arthritis, an overlap of their genetic susceptibility exists. 
Pathophysiologically the "psoriatic march" is a model that describes the 
development of metabolic and cardiovascular diseases due to the presence of 
underlying systemic inflammation. Dermatologists are the gatekeepers to 
treatment for patients with psoriasis. The early detection and the management of 
comorbidity is part of their responsibility. Concepts for the management of 
psoriasis and tools to screen for psoriatic comorbidity have been developed in 
order to support dermatologists in daily practice.