Maybury CM, et al. - Through a prospective observational cohort study of 333 patients with severe psoriasis, the observers sought to assess the prevalence of and evaluate the clinical factors associated with advanced liver fibrosis. In severe psoriasis, advanced fibrosis wasn't uncommon. An association between the presence of advanced fibrosis, abdominal obesity (by waist circumference) and insulin resistance. For future personalized therapeutic decision-making to characterize the hepatic sequelae of central obesity, insulin resistance, and inflammation as well as the influence of systemic drugs (methotrexate and biologics) would be via longitudinal work.