In one study, patients with early-onset psoriasis had significantly elevated serum tumor necrosis factor-α (TNF-α) levels, higher levels of systemic inflammation, elevated serum endothelin levels, and carotid intima-media thickness, suggesting more severe endothelial dysfunction and a higher risk of developing atherosclerosis (Elkamshoushi et al., 2019). Here, TNF is linked to psoriasis.