Psoriasis and the liver: problems, causes and course

Abstract

Liver enzyme abnormalities are common in psoriasis patients and are mostly associated with drugs and NAFLD. Although most cases can be managed by avoiding hepatotoxic medications and close follow up, severe consequences like cirrhosis may develop.

Liver Illness and Psoriatic Patients

“…Idiopathic liver biochemistry disturbance in psoriasis is not a nosographic entity well described in the literature. Tula et al retrospectively reviewed 518 psoriasis patients, of these the liver biochemistry disturbance and the potential relation with the most common risk factors (obesity, diabetes mellitus, alcohol consumption, hepatotoxic medications, dyslipidemia, infectious hepatitis) were evaluated [ 6 ]. Elevation of liver enzymes was defined idiopathic in patients without an identified risk factor: 4% of mild-moderate and 8% of severe elevation of liver function tests [ 6 ].…”

“…Tula et al retrospectively reviewed 518 psoriasis patients, of these the liver biochemistry disturbance and the potential relation with the most common risk factors (obesity, diabetes mellitus, alcohol consumption, hepatotoxic medications, dyslipidemia, infectious hepatitis) were evaluated [ 6 ]. Elevation of liver enzymes was defined idiopathic in patients without an identified risk factor: 4% of mild-moderate and 8% of severe elevation of liver function tests [ 6 ]. However, in our opinion, this percentage (4–8%) cannot be interpreted as idiopathic because the authors (for the retrospective nature of the study) did not evaluate all the possible causes of hypertransaminasemia (e.g., autoimmune disorders, celiac disease, Hemochromatosis, and Wilson's disease) [ 6 ].…”

“…Elevation of liver enzymes was defined idiopathic in patients without an identified risk factor: 4% of mild-moderate and 8% of severe elevation of liver function tests [ 6 ]. However, in our opinion, this percentage (4–8%) cannot be interpreted as idiopathic because the authors (for the retrospective nature of the study) did not evaluate all the possible causes of hypertransaminasemia (e.g., autoimmune disorders, celiac disease, Hemochromatosis, and Wilson's disease) [ 6 ].…”

“…Drug-induced liver injury (DILI) is a leading cause of emergency liver transplantation; it ranges from asymptomatic elevation of liver enzymes to acute liver failure. The elevation of liver enzymes in psoriasis patients is mainly associated with consumption of liver toxic substances (57%) followed by nonalcoholic fatty liver disease (NAFLD) (22%) [ 6 ]. Different drugs taken by patients with psoriasis are reported to be hepatotoxic.…”

Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

“…Psoriasis is proved to be associated with a series of comorbidities especially in severe forms, including the metabolic syndrome, cardiovascular disease and liver abnormalities [2] . Recent studies indicate that drug-induced hepatitis and non-alcoholic fatty liver disease (NAFLD) may account for liver test abnormalities in severe psoriasis patients [3,4] . Considering the risk of abnormal liver function, treatment options need to be chosen carefully in severe psoriasis patients with liver disorder history.…”