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Assessing Metabolic Syndrome in a Patient with Psoriasis

The patient pictured below presents to clinic asking for psoriasis treatment. He has failed topical therapeutics and is requesting a biologic. On exam you note central obesity, while also determining the severity and extent of his psoriasis meets criteria for biologic treatment. Upon further questioning the patient reveals he does not have a primary care physician and cannot remember the last time he had labs checked or underwent a physical examination.

Photo credit: Gisondi, Paolo & Ferrazzi, Anna & Girolomoni, Giampiero. (2010). Metabolic Comorbidities and Psoriasis. Acta dermatovenerologica Croatica : ADC. 18. 297-304.

You are concerned about the association with psoriasis and metabolic syndrome, therefore will include which of the following tests/labs as you work-up this patient (choose all that apply):

I. CBC

II. Blood Pressure Measurement

III. Complete Metabolic Panel in fasting state

IV. Fasting Lipid Panel

I, II, IV

II, III, IV

I, III

I, II, III, IV