Skill Checkup: A 32-Year-Old Man With an Acute Flare of Psoriasis

David T. Robles, MD, PhD, FAAD


May 11, 2022

Psoriasis is strongly associated with type 2 diabetes, BMI, and obesity. There is increasing evidence to suggest that several hypoglycemic agents used in the treatment of type 2 diabetes, including GLP-1 agonists, dipeptidyl peptidase-4 inhibitors, thiazolidinediones, and biguanides, exert beneficial effects in psoriasis.

Several case studies have described significantly improved psoriasis severity in patients receiving GLP-1 agonists for type 2 diabetes. Additionally, thiazolidinediones inhibit proliferation of keratinocytes. A 2012 systematic review and meta-analysis found that pioglitazone significantly decreased psoriasis severity compared with placebo suggesting efficacy for the treatment of psoriasis.

Conversely, current psoriasis therapies may potentially be used to treat type 2 diabetes. For example, tumor necrosis factor-α (TNF-α) blockers are also being evaluated in type 2 diabetes owing to the potential to improve insulin sensitivity.


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