TNF and obesity due to melanocortin 4 receptor deficiency: Both share genetic underpinnings (e.g., variants in HLA-Cw6, CARD14, and cytokine genes) and inflammatory pathways (e.g., TNF-α, IL-6, IL-23/Th17 axis), but environmental interventions—such as lifestyle modifications targeting obesity, smoking, and metabolic syndrome—likely play a larger role in modulating risk than psoriasis severity alone.