Therefore, the aim of the current study was to determine the levels of PAD-4 and its main activator (TNFα) in the serum of psoriatic patients and observe the response of these factors to systemic therapy: anti-IL-17A (ixekizumab, secukinumab), anti-TNFα (adalimumab, infliximab), and methotrexate (MTX), mostly deployed in psoriasis treatment. Here, TNF is linked to psoriasis.