This occurrence affected cirrhotic patients: considering that cirrhosis by any cause is itself a remarkable prooncogenic risk factor, it is difficult to establish the role played by TNF inhibitors, which, however, should be used with caution in psoriatic patient with advanced liver disease [49, 79]; cDMARDs seem safe in HCV patients with psoriasis as for reactivation [49]. This evidence concerns the gene TNF and psoriasis.