Treating psoriasis in patients with concomitant hepatitis C infection presents an intricate challenge. Interferon (IFN) therapy, a mainstay of therapy for hepatitis C virus infection, often exacerbates psoriasis. Moreover, many psoriatic therapies are contraindicated in chronic liver infections due to their potential hepatotoxicity and immunosuppressive effects. The National Psoriasis Foundation (NPF) recently issued a consensus statement regarding the treatment of psoriasis in patients infected with hepatitis C virus (HCV) with the aim of standardizing treatment options and optimally managing psoriasis while minimizing adverse risks for the patients. A patient case is presented here for which the evidence-based treatment guidelines are applied and discussed. By managing psoriasis in patients with coexisting hepatitis C infection in a step-wise manner based on the currently recommended treatments, potential negative complications such as exacerbation of liver disease and dangerous psoriatic flares may be minimized.
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