Psoriasis is a chronic systemic inflammatory skin disorder characterized by hyperproliferation of keratinocytes and significant immune dysregulation. Obesity is markedly associated with psoriasis, acting as an independent risk factor that exacerbates disease severity and treatment failure, while weight‑reduction interventions can improve psoriatic lesions. However, the mechanisms by which obesity promotes the onset and progression of psoriatic lesions still require further elucidation. The present comprehensive narrative review highlighted the critical role of the crosstalk between white adipose tissue (WAT) and skin in the pathogenesis of psoriasis. The expansion of WAT contributes to inflammation, epidermal proliferation and angiogenesis in skin lesions through the release of adipokines, extracellular vesicles and free fatty acids. Conversely, psoriatic lesions induce dysregulation in the inflammation and function of WAT. These findings suggested that this bidirectional communication not only explains the high prevalence of obesity among patients with psoriasis, but also highlights the importance of addressing metabolic comorbidities in treatment strategies. 

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