TNF and metabolic dysfunction-associated steatotic liver disease: Although the studies available in the literature do not allow to clearly determine the directionality of the association between NAFLD and psoriasis, it is conceivable that several pro-inflammatory cytokines (e.g., IL-6, IL-17, TNF-α) that are locally over-produced by lymphocytes and keratinocytes into the skin of psoriatic patients may contribute, at least in part, to the pathogenesis of systemic insulin resistance [29,30], and that psoriatic patients with greater insulin resistance are the ones who get NAFLD.