Psoriasis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesPsoriasisSCE Dermatology

A 55-year-old woman has chronic plaque psoriasis and is concerned about the metabolic effects of her condition. What is the relationship between psoriasis and non-alcoholic fatty liver disease?

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Correct answer: A — Psoriasis is independently associated with NAFLD irrespective of metabolic syndrome

Psoriasis is independently associated with non-alcoholic fatty liver disease (NAFLD), even after adjusting for metabolic syndrome components (obesity, diabetes, dyslipidaemia). This is thought to be mediated by systemic inflammation (shared TNF-alpha, IL-6, IL-17 pathways) and insulin resistance. The association has clinical implications for Methotrexate prescribing (pre-existing liver disease increases hepatotoxicity risk) and biologic selection. NICE guidelines recommend awareness of NAFLD in psoriasis patients. Hepatic steatosis should be considered when interpreting liver function tests and when choosing systemic therapies.

Reference: BAD 2020 Psoriasis Comorbidities; NICE CG153; BJD 2019