Abstract
Objective: The objective of this study is to investigate the association between Vitamin D level and psoriasis, in particular in our city of the long, hot, and sunny weather, in an attempt to add a clarification to this controversial subject.
 Methods: A case–control study included 120 patients with psoriasis and 38 patients with psoriatic arthritis (PsA); 89 (56.3%) patients were male. Psoriasis area and severity index (PASI) was calculated for all patients with psoriasis and disease activity score using 28 joints (DAS28) and erythrocyte sedimentation rate (DAS28) was measured for all patients with PsA. The control group comprised 164 age- and sex-matched participants (91 males and 73 females). Vitamin D serum level was performed for both patients and controls.
 Results: Vitamin D levels in both patients and controls were 17.4±7.7 and 28.3±5.6, respectively. The level of Vitamin D was lower in a patient with disease duration equal and more than 10 years than those with a disease duration <10 years. There is no significant difference in Vitamin D levels between the two patient subgroups. Lower Vitamin D levels were associated with high PASI and high DAS28 in psoriasis and PsA, respectively.
 Conclusion: Patients with psoriasis and PsA associated with low levels of serum Vitamin D. Vitamin D deficiency was found to be associated with long disease duration in both psoriasis and PsA. Patients with active disease have lower Vitamin D levels.
Highlights
Psoriasis is defined as a chronic, non-contagious, multisystem inflammatory autoimmune skin disorder that presents with an erythematous scaly rash on the extensor surfaces and trunk, it affects the scalp, palms, and soles [1]
Lower Vitamin D levels were associated with high Psoriasis area and severity index (PASI) and high disease activity score using 28 joints (DAS28) in both psoriasis and psoriatic arthritis (PsA), respectively
We found a low level of Vitamin D in patients with psoriasis compared to the healthy controls, a result comparable to a study done by Gisondi et al [21] who compared 145 patients with psoriasis to 112 patients with rheumatoid arthritis (RA) and 141 healthy controls and was found significantly lower serum levels of Vitamin D in both the RA and psoriatic patients than in the controls, but no significant difference in Vitamin D level between RA and psoriasis groups, and psoriasis patients presented with 2.5 times greater risk of Vitamin D deficiency than the controls
Summary
Psoriasis is defined as a chronic, non-contagious, multisystem inflammatory autoimmune skin disorder that presents with an erythematous scaly rash on the extensor surfaces and trunk, it affects the scalp, palms, and soles [1]. It may affect the nails in a frequency of 50–79% of patients with skin psoriasis and up to 80% of patients with psoriatic arthritis (PsA) [2]. PsA has heterogeneous presentations and may involve both the axial skeleton (spondylitis and/or sacroiliitis) and the peripheral joints It affects skin, nails, and entheses [7]. We investigated the association between psoriasis and the level of Vitamin D, in an attempt to add another clarification to the current controversy in the available data [15], in particular in our sunny, hot, and long summer city
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