Abstract
BackgroundPsoriasis is a common, chronic relapsing inflammatory skin disease. Lately, there is increasing evidence that psoriasis is more than "skin deep". Epidemiological studies showed that severe psoriasis might have also important systemic manifestations such as metabolic deregulations, cardiovascular disease (CVD) and increased mortality. Moreover, recently psoriasis patients were found to have platelet hyperactivity.Case PresentationThis is a case report and review of the literature. We present a patient with long standing severe psoriasis vulgaris with marked thrombocytosis. His thrombocytosis did not correlate with disease severity but rather with the different treatments that he was exposed to, subsiding only during treatment with anti Tumor Necrosis Factor (TNF)- agents. A literature review revealed that in rheumatoid arthritis, another systemic inflammatory disease; interleukin (IL)-6 might be implicated in causing thrombocytosis.ConclusionThis unique case report illustrates that different systemic treatments for psoriasis might have implications beyond the care of skin lesions. This insight is especially important in psoriasis patients in view of their deranged hemostatic balance toward a prothrombotic state, which might increase the risk of thrombosis and CVD. Therefore, further studies analyzing the effect of different drugs on platelets physiology are warranted.
Highlights
ConclusionThis unique case report illustrates that different systemic treatments for psoriasis might have implications beyond the care of skin lesions
Psoriasis is a common, chronic relapsing inflammatory skin disease
This insight is especially important in psoriasis patients in view of their deranged hemostatic balance toward a prothrombotic state, which might increase the risk of thrombosis and cardiovascular disease (CVD)
Summary
Different anti psoriasis therapies might have different effects on platelet physiology. In view of the increased risk of thrombosis and CVD in severe psoriasis patients further studies analyzing the effect of different drugs on platelets physiology are warranted. Competing interests The authors declare that they have no competing interests. Authors' contributions All persons who meet authorship criteria are listed as authors: BBD participated in the design, analysis and wrote the manuscript. MMSW and PG helped with the acquisition of data and manuscript revision with the acquisition of data and manuscript revision. JGK participated in the design, analysis and revised the manuscript. All authors have given final approval of the version to be published. Author Details Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.
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