Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.315
Peer-review started: August 28, 2014
First decision: September 18, 2014
Revised: November 27, 2014
Accepted: December 16, 2014
Article in press: December 16, 2014
Published online: March 27, 2015
Psoriasis is a chronic inflammatory immune-mediated skin diseases which is frequently associated to comorbidities. Non-alcoholic fatty liver disease (NAFLD) is defined as an excessive accumulation of triglycerides in hepatocytes and includes a wide spectrum of liver conditions ranging from relatively benign steatosis to non-alcoholic steatohepatitis with fatty infiltration and lobular inflammation and to cirrhosis and end-stage liver disease. Actually, psoriasis is considered a systemic diseases associated to comorbidities, as metabolic syndrome and NAFLD is seen the hepatic manifestation of the metabolic syndrome. The possible link between psoriasis, obesity and metabolic syndrome, which are known risk factors for NAFLD has been recently documented focusing in the crucial role of the adipose tissue in the development of the inflammatory background sharing by the above entities. According to recent data, patients with psoriasis show a greater prevalence of NAFLD and metabolic syndrome than the general population. Moreover, patients with NAFLD and psoriasis are at higher risk of severe liver fibrosis than those with NAFLD and without psoriasis. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple aspects linking NAFLD and psoriasis, only apparently far diseases.
Core tip: The review focuses on the multiple physio-pathogenetic aspects of the possible link between psoriasis and non-alcoholic fatty liver disease (NAFLD) emphasizing the most recent scientific data. The importance of the multidisciplinary approach to patients affected by psoriasis is underlined and the therapeutic options to treat concomitant psoriasis and NAFLD is discussed evaluating the risk benefit of both biologic and non-biologic therapies.