A commentary on a recent article by Abuabara et al. (Br J Dermatol 2010, 163: 586) was published. This concerned the increased risk of serious comorbidities associated with severe psoriasis, especially cardiovascular disease (CVD). However, if patients have a low baseline risk of CVD, even a threefold increase may not be significant for that patient. New therapies such as biologicals can control severe psoriasis effectively and improve quality of life. Whether they can also decrease the prevalence and/or impact of various comorbidities and increase lifespan are currently unresolved issues (Feldman, S.R. Br J Dermatol 2010, 163: 449).