Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities, such as psoriatic arthritis, Crohn's disease, malignancy, obesity, and cardiovascular diseases. These factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis that has led to identification of new therapeutic targets. Several new drugs have gained approval by the US Food and Drug Administration, expanding the psoriasis armamentarium, but still a large number of patients continue to be untreated or undertreated. Treatment regimens for psoriasis patients should be tailored to meet the specific needs based on disease severity, the impact on quality of life, the response to previous therapies, and the presence of comorbidities. The first article in this continuing medical education series focuses on specific comorbidities and provides insights to choose appropriate systemic treatment in patients with moderate to severe psoriasis.

牛皮癣是一种全身性炎症性疾病，与合并症的风险增加有关，例如牛皮癣性关节炎，克罗恩氏病，恶性肿瘤，肥胖症和心血管疾病。这些因素对决定使用一种疗法而不是另一种疗法有重大影响。在过去的十年中，我们对银屑病发病机理的理解发生了范式转变，从而导致了新治疗靶标的确定。几种新药已获得美国食品和药物管理局的批准，扩大了牛皮癣病的治疗范围，但仍有大量患者仍未接受治疗或未得到充分治疗。应根据疾病的严重程度，对生活质量的影响，对先前疗法的反应以及合并症的存在，对牛皮癣患者的治疗方案进行调整，以满足其特定需求。