Psoriasis is a chronic inflammatory skin disease with complex comorbidities. Recent evidence has revealed how the inflammatory nature of psoriasis affects bone mineral density and may lead to osteoporosis. This review outlines the current understanding and advances on the association between psoriasis and osteoporosis. The current literature suggests an increased risk of osteopenia and osteoporosis in patients with extensive and chronic psoriasis, compounded by other lifestyle and genetic factors. It suggests that prophylactic measures such as vitamin D supplementation and increasing weight-bearing exercises can help, but in patients with extensive psoriasis, prolonged systemic inflammation may require long-term management. Although there have been many short-term RCTs on the efficacy and safety of biologics in psoriasis, clinical studies looking at the long-term effects of biologics, such as whether they might improve bone mineral density in these patients with psoriasis are yet to be conducted.
© 2022 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.