New Insights into Psoriasis: Residual Inflammation Linked to Obesity and Fatty Liver Disease

Recent research has shed light on the persistent systemic inflammation found in psoriasis patients, even when their skin symptoms are well-controlled with biologic therapies. The study, published in the Journal of Investigative Dermatology, demonstrates that a significant portion of psoriasis patients—36.3%—still exhibit residual inflammation. This lingering inflammation is strongly associated with higher body mass index (BMI), metabolic-related fatty liver disease (MASLD), increased systemic inflammation, and excess adipose tissue.

The research was conducted across three international cohorts from Spain, the U.S., and Sweden, involving 209 patients who had achieved a PASI score of 2 or less—indicating minimal or no visible skin symptoms—while on stable biologic treatment. Despite good skin response, the presence of residual inflammation highlights an unmet need in managing the full spectrum of psoriasis, which is increasingly recognized as a systemic inflammatory condition.

Lead researcher Dr. Álvaro González-Cantero from Universidad Francisco de Vitoria emphasizes that psoriasis’s systemic nature contributes to higher risks of comorbidities, including cardiovascular disease and reduced life expectancy. The study suggests that addressing inflammation related to obesity, liver health, and metabolic dysfunction could improve long-term outcomes.

Specialist Alba Lecumberri notes the importance of cardiovascular risk assessment in patients with residual inflammation, advocating for more comprehensive monitoring of inflammatory and liver-related markers. Experts like Dr. Michael Garshick reinforce that systemic inflammation in psoriasis patients warrants broader treatment strategies beyond skin symptom management.

The findings point toward a holistic approach to psoriasis care, integrating lifestyle modifications, weight management, and targeted therapies to reduce systemic inflammation and address associated metabolic conditions. Further research is needed to confirm these findings and develop effective interventions aimed at the systemic inflammatory burden in psoriasis.

This study underscores the importance of understanding psoriasis as a systemic disease, emphasizing that skin control alone is insufficient for optimal patient health. A multidisciplinary approach involving dermatologists, cardiologists, and other specialists could lead to better management of these complex comorbidities.

Source: https://medicalxpress.com/news/2025-05-links-residual-inflammation-psoriasis-patients.html