A new international study has shed light on the hidden dangers of psoriasis, revealing that this chronic skin condition may carry greater health risks than previously understood. Researchers have found that even patients who respond well to treatment for psoriasis may continue to harbour residual systemic inflammation, increasing their susceptibility to obesity, fatty liver disease, and cardiovascular problems.
More Than Skin Deep: Psoriasis as a Systemic Condition
Psoriasis is widely known for its red, scaly skin lesions, but experts say the condition goes far beyond skin-deep. It is increasingly being recognised as a systemic inflammatory disorder. A recent observational study, published in the Journal of Investigative Dermatology, reinforces this view by linking residual inflammation in psoriasis patients to metabolic conditions such as obesity and fatty liver disease.
“Despite excellent control of skin disease, a substantial percentage of psoriasis patients demonstrate residual systemic inflammation,” said Dr. Joel M. Gelfand of the Perelman School of Medicine at the University of Pennsylvania. His comments emphasise the need for a broader approach in managing the disease — one that addresses not only visible symptoms but also the underlying inflammation that persists in the body.
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The Scope of the Study
Researchers evaluated 209 patients across three countries — the United States, Spain, and Sweden — all of whom had mild or no visible symptoms of psoriasis and were on stable biologic therapy. These therapies are typically used to suppress the immune system and reduce inflammation.
Surprisingly, about 36.3% of these patients still exhibited residual inflammation. The researchers discovered that this lingering inflammation was significantly associated with a higher body mass index (BMI), greater adipose (fat) tissue, and signs of metabolic dysfunction-associated steatotic liver disease (MASLD), commonly known as fatty liver.
The Inflammation-Obesity Connection
Lead investigator Dr Álvaro González-Cantero from Hospital Universitario Ramón y Cajal in Spain pointed out that these findings bring to light an important gap in psoriasis treatment. “The findings underscore a critical unmet need to address the systemic inflammatory burden beyond skin symptoms in psoriasis,” he said.
The data suggests that managing psoriasis effectively may require more than just dermatological treatment. The link between psoriasis, obesity, and fatty liver highlights how systemic inflammation can persist and fuel other health complications, even when skin symptoms improve.
Call for Comprehensive Health Monitoring
Given the study's findings, researchers are calling for more holistic patient care. This includes regular monitoring of high-sensitivity C-reactive protein (hs-CRP), a biomarker for inflammation, and tests for liver health. Clinicians may need to work alongside dietitians and other specialists to create individualised plans that incorporate weight management, physical activity, and anti-inflammatory diets.
Lifestyle interventions — such as reducing calorie intake, avoiding processed foods, and increasing physical activity — could not only improve psoriasis outcomes but also reduce the risk of developing serious comorbidities.
Looking Ahead: The Need for Further Research
While the study provides compelling evidence, the authors emphasise that further research is necessary. Larger, long-term studies are needed to understand the exact mechanisms that drive residual inflammation in psoriasis patients and to explore whether early lifestyle interventions can mitigate these risks.
Until then, the takeaway is clear: psoriasis should be viewed as a whole-body condition, not just a skin disease. Patients and healthcare providers alike must remain vigilant about the broader health implications, particularly concerning obesity and liver health.