Nonalcoholic steatohepatitis associated with psoriasis vulgaris

Abstract

A 24-year-old man was admitted to our hospital because of liver dysfunction. He had been diagnosed as having psoriasis vulgaris at 18 years of age. Physical examination demonstrated obesity, general erythema, and hepatomegaly. Laboratory data revealed elevated serum levels of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and glucose. A histological examination of the liver revealed macrovesicular fatty change and infiltration of inflammatory cells, including lymphocytes and polymorphonuclear cells, within the liver lobules. Pericentral fibrosis and pericellular fibrosis were also recognized. He was diagnosed as having nonalcoholic steatohepatitis (NASH), based on the fact that he had no habit of drinking alcohol, as well as psoriasis vulgaris and diabetes mellitus. We herein report a very rare case of NASH associated with psoriasis vulgaris.

A series of critically challenging case scenarios in moderate to severe psoriasis: A Delphi consensus approach

“…65 This raises the question of prevalence of NAFLD in patients with psoriasis. Several case reports document their coexistence [66][67][68] and, given that obesity is nearly twice as prevalent in psoriasis as in the general population, 69,70 a substantial number of individuals with both conditions would be expected. At this time, data regarding psoriasis therapy in this group are limited to methotrexate (Grade B evidence).…”

Clinical features of nonalcoholic steatohepatitis in Japan: evidence from the literature

“…1,2 This disease was very important at that time because it freis likely not a disease but a syndrome resulting from different combinations of susceptibility genes superimposed on different nongenetic factors. [12][13][14][15][16][17][18][19][20][21] There may be differences in the genetic and nongenetic background for the development of NASH between the general population in Asian countries and that in Western countries. For these reasons, we need to assess whether the clinical and epidemiological characteristics of NASH patients learned from studies in Western countries are applicable to NASH patients in the Asia-Pacific area.…”

Psoriasis vulgaris and digestive system disorders: is there a linkage?

“…It raised the question whether the organ was the subject to the same disorder as the skin, inasmuch accumulation of neutrophils in the epidermis is one of the vital histological features of pustular psoriasis [12,13]. Apart from biliary involvement in the course of pustular psoriasis, nonalcoholic steatohepatitis was linked to psoriasis vulgaris [10,11]. The fatty liver change related to psoriasis vulgaris were noted in the "POLI.ST.E.N.A."…”

“…A few authors have related psoriasis and disturbances of the incretory and excretory pancreatic functions and even acute pancreatitis [7][8][9]. Single reports on liver dysfunction or chronic liver disease in psoriatic individuals have been published, including hepatic cirrhosis or psoriasis being a cutaneous sign of hepatocellular carcinoma [10][11][12][13][14].…”

“…Disposition to psoriasis is primarily genetic, but some dysmetabolic changes, such as obesity, dyslipi-daemia, hyperuricaemia, impaired glucose tolerance or insulin resistance, may increase the risk for psoriasis as well as for some of the digestive system disorders, especially liver diseases [10][11]. On the other hand, pro-inflammatory factors upregulated in psoriasis, especially interleukin (IL) 18, are likely to increase risk of the metabolic syndrome [15].…”