Severity of psoriasis related to the severity of fatty liver disease

The severity of psoriasis is associated with the severity of non-alcoholic fatty liver disease (NAFLD), according to new findings presented at the 28th European Academy of Dermatology and Venereology (EADV) Congress in Madrid, Spain.

In a prospective, 12-month study patients with psoriasis and NAFLD had more severe hepatic damage if they had a higher severity of psoriasis, based on ultrasound elastography measurements. 

Researchers from La Paz Hospital in Madrid investigated 64 male patients diagnosed with severe psoriasis and NAFLD, who had a mean age of 53.4 years. The severity of psoriasis was measured by using the Psoriasis Area and Severity Index (PASI) Score. Ultrasound elastography, which maps the elastic properties of soft tissue, was used to evaluate the stiffness of the liver and detect NAFLD. Stiffer liver tissue is usually indicative of NAFLD or liver fibrosis, which can cause cirrhosis, and end-stage liver disease, the researchers said.

Results of the study showed that psoriatic patients with NAFLD had a more severe elatographic hepatic damage if they had a higher level of psoriasis severity.

Psoriasis is a chronic, non-communicable skin disease characterized by bright, silvery-white scales on reddened inflamed patches of skin, mainly on the arms and legs, the scalp, but also on many other areas of the body, including the genitals. NAFLD is the most common diffuse liver disease, with a worldwide prevalence of 20 percent to 46 percent.

The relationship between the severity of psoriasis and NAFLD in psoriasis patients is also supported by newly released findings from a separate descriptive study, which was conducted by researchers based in Iran, in 54 male psoriasis patients. Analyses from the Iranian study showed that the prevalence of NAFLD was high in patients with psoriasis and the severity of the NAFLD increased in high-grade psoriasis cases. Also, the severity of the NAFLD had a positive correlation with the grade of psoriasis, which is due to pro-inflammatory cytokines and adipocytokine. Cytokines trigger psoriasis and increase the severity of the disease.

The severity of psoriasis in the Iranian study was also assessed by using PASI Score, and the different factors of NAFLD were measured. The data collected were analyzed by using SPSS16 statistical software and chi-square, in addition to Fisher exact test.

"Previous research has already established a link between psoriasis and NAFLD,” said Daniel Nieto, said Daniel Nieto, PhD, lead researcher of the study. “This is one of the first studies to assess the relationship between the severity of psoriasis with the severity of NAFLD. In this context, increasing awareness and the continued assessment of the severity of NAFLD in patients with psoriasis by primary care physicians, specialists, health policy makers and patients, should be prioritized to help manage both conditions."