Comorbidities in Autoimmune Skin Diseases

Alvan Feinstein, both a clinician and an epidemiologist, introduced the concept of comorbidity as a peculiar and important feature of chronic diseases almost 50 years ago. This concept may still require a more precise definition and a deeper understanding, but there is no doubt that better knowledge about comorbidities will always be conducive to improvements in clinical care, epidemiology, and health services planning and financing. Also, as noted by Tinetti and Fried nearly 15 years ago, awareness of existing comorbidities of a given chronic disease will facilitate "The End of the Disease Era," as they titled their article, and ultimately bring about the essential paradigm shift in clinical medicine from the "disease-oriented" model to a more "integrated individually tailored model" in which clinical decision making can be "focused primarily on the priorities and preferences of individual patients,"^(p181) and health conditions are recognized as a complex interplay of genetic, environmental, psychological, social, and other factors.