16 Febbraio 2022
Deepak M W Balak, Stefano Piaserico, Ismail Kasujee

Non-Alcoholic Fatty Liver Disease (NAFLD) in Patients with Psoriasis: A Review of the Hepatic Effects of Systemic Therapies

Psoriasis (Auckl). 2021 Dec 7;11:151-168

Key messages

  • Una revisione sulla letteratura recente relativa alla correlazione epidemiologica e fisiopatologica tra psoriasi e non-alcoholic fatty liver disease (NAFLD),
  • Si discutono le implicazioni cliniche della NAFLD nei pazienti con psoriasi e riassume il potenziale epatotossico ed epatoprotettivo delle terapie sistemiche per la psoriasi.


There is increasing interest in the association between psoriasis and non-alcoholic fatty liver disease (NAFLD), which is a prevalent liver disease characterized by excessive fat storage and inflammation that can progress to fibrosis and cancer. Patients with psoriasis have a two-fold higher risk to develop NAFLD and a higher risk to progress to more severe liver disease. Psoriasis and NAFLD share common risk factors such as smoking, alcohol consumption, and the presence of metabolic syndrome and its component disorders. In addition, both psoriasis and NAFLD hinge upon a systemic low-grade inflammation that can lead to a vicious cycle of progressive liver damage in NAFLD as well as worsening of the underlying psoriasis. Other important shared pathophysiological pathways include peripheral insulin resistance and oxidative stress. NAFLD should receive clinical awareness as important comorbidity in psoriasis. In this review, we assess the recent literature on the epidemiological and pathophysiological relationship of psoriasis and NAFLD, discuss the clinical implications of NAFLD in psoriasis patients, and summarize the hepatotoxic and hepatoprotective potential of systemic psoriasis therapies.

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