Prevalence of non‐alcoholic fatty liver and liver fibrosis in patients with moderate–severe psoriasis: A cross‐sectional cohort study

Background/Objectives Several studies have reported that non‐alcoholic fatty liver disease (NAFLD) is more frequent in patients with psoriasis, but few have reviewed the presence of liver fibrosis in those patients. Methods Cross‐sectional cohort, single‐centre study, continuously selecting all patients with moderate–severe psoriasis seen at the Psoriasis Unit of a Tertiary Hospital. The grade of liver steatosis was assessed using liver ultrasound, and the quantity of liver fibrosis was graded using a transitional vibration‐controlled elastography (Fibroscan®). Results A total of 71 patients (66.2% male) were included, with an average age of 46.6 years old. The maximum historical PASI average was 14.4 while the baseline PASI average at the time of the study was 2. A third (36%) of patients met the criteria for metabolic syndrome 52% of patients had steatosis; being male, having metabolic syndrome comorbidities, elevated AST/ALT enzymes, dyslipidemia and high initial PASI were significantly related. 14% of patients had moderate liver fibrosis (≥7.6 KPa). In 30% of them, no ultrasound liver steatosis was observed. Conclusions Elastography may be a useful tool along with ultrasound to evaluate liver disease in patients with psoriasis.