Psoriasis has seen a dramatic change in its perception by dermatologists as well as other medical specialties. Its well-recognized association with several other diseases makes a complete switch in its management necessary. This review summarizes current epidemiological data on the comorbidities of psoriasis. Subsequently, the evidence for insulin resistance as a cause for endothelial cell dysfunction with its relevant pathogenetic link to the development of cardiovascular comorbidity is discussed. Based on these novel insights, we propose a possible state-of-the-art approach towards comprehensive psoriasis management.