Unexpected Hepatotoxicity in Psoriasis: Deranged Liver Enzymes and Steatosis Secondary to Secukinumab Treatment.

Psoriasis is a chronic inflammatory disease characterized by scaly, erythematous plaques on any part of the body, especially the extensor surfaces. Secukinumab, an IL-17A inhibitor, is widely used clinically for conditions such as psoriasis and psoriatic arthritis with a good prognosis and minimum side-effect profile. Although rare, it can predispose to various significant infectious side effects, including bacterial and fungal infections, owing to its immunosuppressive and neutropenic effects. It has been associated with stable metabolic parameters, but some studies have reported metabolic disturbances with the IL-17A inhibitor therapy. We report a case of deranged liver studies along with fatty changes on ultrasound in a patient with psoriasis undergoing secukinumab therapy for 6 months, with significant improvement in skin and joint symptoms.