Psoriasis and metabolically associated liver disease. Justification of hepatotropic therapy in complex therapy of patients with psoriasis

Abstract

Psoriasis is a chronic, relapsing, immune-mediated inflammatory skin disease characterized by an increased risk of several comorbidities, including metabolic syndrome, type 2 diabetes, and metabolic-associated liver disease (MAFLD). The effect of systemic inflammation and insulin resistance worsens the condition of the liver, and liver disorders negatively affect the course of psoriatic disease.In our research, we studied the effect of additional use of the standard hepatoprotector silymarin and the modern phytosomal complex silibinin in combination with soy phospholipids to local GCS therapy. The functional state of the liver was determined based on the liver fibrosis index (NAFLD Fibrosis Score), and the dynamics of psoriatic skin lesions was monitored using the Psoriasis Area and Severity Index (PASI).The study included 60 patients who were divided into 3 groups: all patients used standard local monotherapy with a topical GCS (mometasone furoate, «Elokom®» drug) for 9 weeks. At the same time, patients of the second group received the classical silymarin drug, and patients from the third group received a modern phytosomal silibinin complex in combination with soy phospholipids («Lesyl®» drug).The results of our study showed that the use of a complex preparation of silibinin in combination with phospholipids demonstrated better dynamics of liver function indicators compared to the usual preparation of silymarin. We also observed the best results of regression of psoriatic rashes according to the dynamics of PASI index in this group.The obtained results prove that the correction of liver disorders in patients with psoriasis will not only have a positive effect on their metabolic background and the state of the body as a whole, but will also contribute to increasing the effectiveness of dermatosis treatment.