Hidradenitis suppurativa and psoriasis: shared immunological links with metabolic-associated steatotic liver disease

Chronic inflammatory skin conditions such as hidradenitis suppurativa and psoriasis vulgaris exhibit a significantly elevated prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), with studies indicating rates as high as 57% among affected individuals. This narrative review explores the underlying immunological mechanisms that connect HS and psoriasis with MASLD, emphasising the role of chronic systemic inflammation, immune dysregulation, and shared immunologic links between the diseases. This article also urges for enhanced awareness among dermatologists regarding the potential pharmacological interventions for patients with concurrent HS or psoriasis and MASLD, including glucagon-like peptide-1 receptor agonists and biologics, while acknowledging the need for further research to elucidate the efficacy and safety of these treatments.