Homeostatic Mechanisms for the Compensation of Cutaneous Sulfur Losses

Abstract

It has been repeatedly observed that psoriatic patients Will maintain an adequate nutritional status even in the presence of chronic generalized exfoliation (1). Indeed, it has been demonstrated that exfoliation of 17 gm. of scale per square meter of body surface per day is necessary before negative nitrogen balance occurs (2). Even at this level of cutaneous loss, clinical evidence of protein malnutrition has not been observed unless such complicating factors as serum loss are present or corticosteroids are administered. These observations have suggested that homeostatic mechanisms exist for the compensation of these nutrient losses from the skin. This hypothesis does not rest primarily on any theory of the kinetics of the psoriatic process (3), but rather on the general physiological concept of the maintenance of the milieu interieur. It Was considered desirable to investigate the problem of homeostatis utilizing sulfur balance techniques since sulfur losses from the integument can be correlated directly With scale loss (4). Studies have therefore been conducted to compare the sulfur losses in a group of psoriatic patients with those in a control group of subjects.