Psoriatic Group Research Articles

Evaluating the Femoral Atherosclerotic Plaque in Psoriasis Patients and Controls: A Case-Control Study

Background Psoriasis is a chronic inflammatory disease that can affect the skin or the cardiovascular system. The presence of femoral atherosclerotic plaque could be a promising sign in predicting cardiovascular risk for these patients. Objective The study aims to evaluate the prevalence of femoral atherosclerotic plaque between psoriasis and control individuals. Methods This case-control study involved 40 patients diagnosed with vulgaris psoriasis and 40 non-psoriasis individuals matched by age group and gender. We used clinical signs and symptoms to diagnose psoriasis and evaluated the disease’s severity using the Psoriasis Area and Severity Index (PASI). The atherosclerotic plaque on the femoral artery was detected using Doppler ultrasound to measure the femoral artery intima-media thickness (fIMT). Data were analyzed by SPSS 25. Results Male patients accounted for the proportion of 72.5%. In the psoriatic group, the mean value of PASI was 12.91 ± 6.73 (points). The proportion of femoral atherosclerotic plaque was significantly higher in the psoriasis compared to the controls (32.5% vs 10%; P = 0.014). Some factors associated with the femoral atherosclerotic plaque include age, smoking, and hypertension ( P < 0.05). Hypertension was an independent risk factor for femoral atherosclerotic after regression analysis. Conclusion Femoral atherosclerotic plaque is higher in psoriasis patients. This result emphasizes the need to screen for cardiovascular comorbidities in these patients.

Impact of Genital and Non-Genital Psoriasis on Genital Self-Image, Quality of Life, and Sexual Dysfunction in Female Patients.

Psoriasis is a chronic systemic inflammatory disease that affects millions of people worldwide. While its physical manifestations are well-documented, the psychosocial impact of psoriasis, particularly on female patients, is an area of growing concern. Feelings of shame, inferiority, and stigma are common among individuals with psoriasis, and these emotional burdens can be especially pronounced in females, particularly when the genital area is affected. We aimed to shed light on the significance of genital psoriasis on the overall well-being of female patients. This cross-sectional, descriptive comparative study comprised 50 female participants diagnosed with psoriasis: 25 with genital psoriasis, 25 without genital psoriasis, and 25 healthy women matched for age and sex who served as the control group. All participants underwent an assessment of disease severity using the Psoriasis Area and Severity Index in the psoriasis group and completed questionnaires for the assessment of the Female Sexual Function Index (FSFI). Additionally, quality of life was evaluated using the Dermatology Life Quality Index, and the Female Genital Self-Image Scale (FGSIS) was used to assess genital self-image. We found that females with genital lesions, experience a notable decline in sexual health with higher levels of sexual distress compared to healthy individuals. In terms of the six FSFI domains, the psoriatic group scored lower than the control group in all areas, except for pain, which showed a significant increase. Psoriatic females also exhibited a significantly more negative FGSIS compared to the control group, and there was a highly significant difference in FGSIS between females with and without genital psoriasis. Understanding the impact of genital psoriasis on female sexual health and overall quality of life is essential for comprehensive patient care. This research is instrumental in addressing the psychosocial aspects of psoriasis and enhancing patient well-being.

Formulation Development and Characterization of Acitretin Proniosomal gel: In-vivo Exploration against Imiquimod-induced Psoriasis in Experimental Animals

he main purpose of this study was to prepare and evaluate acitretin proniosomal gel (APG) and find out if the antipsoriatic formulation could prevent Imiquimod (IMQ) induced psoriasis in experimental animals. APG was developed and by coacervation phase separation method. Cholesterol and soya lecithin was used as membrane modifiers and tween 80 and span 60 as non-ionic surfactants. Characterization of the prepared proniosomal gel revealed that the optimized batch APG3 presented excellent formulation characteristics like the viscosity of 9710 ± 1.24 cps, rate of spontaneity as 13 ± 0.86, %entrapment efficiency of 94.91 ± 0.51, average hydrodynamic diameter of niosomes as 345.7 nm, polydispersibility index as 0.159 and ZP of -2.3 mV. In-vivo animal study of the optimized batch APG3 was performed along with biochemical estimations of oxidative parameters as glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase; also, TNF-α, IL-6 were estimated using ELISA sandwiched. Histopathological estimation along with psoriasis area severity index (PASI) scores in the IMQ-induced psoriatic model presented a significant fall in the scoring after treatment with APG3 compared with a psoriatic group. Primary dermal irritation scoring was also evaluated on Sprague Dawley rats. The results presented a considerable decline in skin irritation score compared with a psoriatic group. Also, the levels of GSH, SOD and catalase were increased in APG3 treated group as compared with a psoriatic group. While MDA level is decreased after topical treatment with APG3 compared with a psoriatic group. In conclusion, the optimized APG3 showed promising pharmacological effects in the treatment of psoriasis.

Design and Characterization of Calcipotriol Proniosomal Gel: In-vivo Exploration against Imiquimod-induced Psoriasis in Experimental Animals

The present work focuses on the preparation and evaluation of calcipotriol proniosomal gel (CPG) and find out if the antipsoriatic formulation could prevent imiquimod (IMQ) induced psoriasis in experimental animals. CPG was designed and developed by the coacervation phase separation method. Cholesterol and soya lecithin was used as membrane modifiers and tween 80 and span 60 as non-ionic surfactants. The developed proniosomal gels were characterized which revealed that the optimized batch CPG3 presented excellent formulation characteristics like viscosity of 9690 ± 1.43 cps, rate of spontaneity as 14 ± 1.37, %entrapment efficiency of 82.71 ± 0.48, the average hydrodynamic diameter of niosomes as 739.1 nm, polydispersibility index as 0.360 and ZP of -2.8 mV. In-vivo animal study of the optimized batch CPG3 was performed along with biochemical estimations of oxidative parameters such as glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase; also, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) were estimated using enzyme-linked immunoassay (ELISA) sandwiched. Histopathological estimation along with psoriasis area severity index (PASI) scores in the IMQ-induced psoriatic model revealed a significant decline in the scoring after treatment with CPG3 compared with a psoriatic group. Primary dermal irritation scoring was also evaluated on Sprague Dawley rats. The results revealed a considerable decrease in skin irritation score compared with a psoriatic group. Also, the levels of GSH, SOD and catalase were raised in CPG3 treated group as compared with a psoriatic group. While MDA level was declined after topical treatment with CPG3 compared with a psoriatic group. In conclusion, the optimized CPG3 showed promising pharmacological effects in the treatment of psoriasis

Ultrasonography Enthesitis and Synovitis Screening in Psoriatic Patients: A Case Control Study.

The clinical screening of enthesitis and synovitis in patients with psoriasis lacks specificity and sensitivity during the preclinical phase. to assess US subclinical synovitis and enthesitis in psoriatic patients compared with healthy controls. A cross-sectional study on 40 psoriatic patients and 40 healthy sex- and age-matched controls. US examination of 18 joints was performed along with 22 entheseal sites on the upper and lower limbs. US subscores were established according to the US abnormalities: inflammatory score (tendon thickening, hypoechogenicity, bursitis, Doppler signal), damage score (calcification, enthesophytes, bone erosion) and total score (the sum of inflammatory and damage scores). US synovitis were more frequent in psoriatic patients (0.68%) than in controls (0.29%), but the difference was not significant. Patients with psoriasis had more US enthesitis (92,5%) compared to controls (40%)(p<0.001). The total number of enthesitis was higher in the psoriatic group (20.90%) compared to controls (4,78%)(p<0.001). There were more US abnormalities in the psoriatic group compared to controls for calcaneal tendon enthesis(p<0.001), distal patellar tendon enthesis(p<0.001) and deep flexor tendons of the finger enthesis(p<0.001). Compared to controls, psoriatic patients had a significantly higher inflammatory score (Mean±SD) (2.85±3.34 versus 0.58±1.17), damage score (3±2.57 versus 0.60±1.41), and total score (5.85±5.20 versus 1.18±2.07) (p < 0.001 each). Patients with scalp psoriasis had more US enthesitis (p=0.020). Our results indicate that US enthesitis and synovitis are more frequent in patients with psoriasis. Prospective studies with larger sample size are needed to define the contribution of US in predicting the clinical onset of PsA.

Serum Levels of 25-Hydroxyvitamin D in Chronic Plaque Psoriasis

Background: Psoriasis is an immune mediated inflammatory disease that involves the innate and acquired arm of immunologic system. The regulatory role for vitamin D in immune system is suggested by presence of vitamin D receptors on activated lymphocytes and suppressive or inhibiting effect of 1,25-dihydroxyvitamin D in different autoimmune diseases. Hence, the current proposed study aims to study the 25-hydroxyvitamin D status of patients with psoriasis.&#x0D; Objective: The primary objective of this study was to analyze the 25-hydroxyvitamin D status of patients with chronic plaque psoriasis in comparison to healthy control subjects.&#x0D; Materials and Methods: A comparative cross-sectional study, including forty patients with chronic plaque psoriasis and forty age- and sex-matched control subjects, was conducted from April 2021 to December 2022, at our dermatology department. After informed consent, all patients were subjected to detailed clinical and anthropometric examination. Serum concentration of 25-hydroxyvitamin D was evaluated in chronic plaque psoriasis cases and healthy control subjects. Data was be analyzed as per standard statistical protocol.&#x0D; Results: The mean serum 25-hydroxyvitamin D level in psoriatic group and control group were 18.02 (±SD 9.82) ng/ml and 24.47 (±SD 6.77) ng/ml, respectively. (p=.001) Serum 25-hydroxyvitamin D was negatively correlated with Psoriatic area and severity index (PASI) score (r=-.11). However, this correlation was not significant (p=.493).&#x0D; Conclusion: Serum 25-hydroxyvitamin D levels were significantly lower in psoriatic patients than in control subjects.

Can Serum Fetuin-A be Used as a Marker for Cardiovascular Involvement in Psoriatic Patients?

Psoriasis is a systemic inflammatory disorder. It is associated with increased risk of developing other chronic health diseases such cardiovascular disorders. Fetuin A is a glycoprotein that is present in blood serum. It may prevent vascular calcification by forming calciprotien particles; which are formed from their attachment with phosphate and calcium complexes. The aim of this study was to measure serum Fetuin A in Psoriatic patients and correlate its level with cardiac events and risks in these patients using CT calcium (Ca) scoring. 24 psoriatic patients (healthy without apparent cardiac risks to detect subclinical events if present) and 24 age and sex matched controls were tested for serum Fetuin A and underwent coronary calcium scoring by multidetector computed tomography (CT) scan. Psoriasis area and severity index (PASI) score for each patient was measured and was correlated with serum Fetuin A and CT calcium (Ca) scoring. Serum Fetuin A was compared between cases and controls and was correlated with coronary calcium score. There was highly statistically significant decrease in serum Fetuin A level in psoriatic group compared to control group (P-value < .001). There was highly statistically significant negative correlation between calcium score and the level of serum Fetuin A (P-value < .001). No statistically significant correlation was found between the serum level of Fetuin A and the psoriasis severity. Serum Fetuin A is a simple, easy diagnostic tool to evaluate subclinical atherosclerosis in psoriatic patients.

The Correlation between Interleukin 33 and Psoriasis: A Systematic Review and Meta-Analysis

Psoriasis is a common genetic autoimmune disorder with a global prevalence of 2–3%. The clear pathogenesis of psoriasis is not fully understood, but hyperproliferation and inflammation of the epidermis with marked infiltration of immune cells have been indicated in psoriasis with such cells producing different types of cytokines- interleukin. As such a new member of the IL-1 cytokine family, in some research, IL-33 has been linked with psoriasis showing high serum concentration of IL-33 in human psoriatic plaques compared to normal healthy skin. Despite this, the association between IL-33 and psoriasis is not clear. Herein, in this review, we aim to investigate the correlation between serum IL-33 levels and psoriasis. We conducted meta-analysis using fixed or random-effects models to calculate pooled standard mean differences. We found that the mean IL-33 serum levels were reported between 0.35 pg/mL to 586 pg/mL in the psoriatic group and 0 pg/mL to 87.7 pg/mL in the healthy control group. Out of five, four individual studies included in the analysis reported statistically significant differences in IL-33 levels, the pooled estimate (SMD = 0.340 95% CI: −0.308 to 0.988), however, did not indicate a significant relation between IL-33 and psoriasis. This analysis revealed no significant difference between serum IL-33 levels in the psoriatic population in comparison to healthy controls. This may be because we did not include any animal studies, lab-based studies, any other markers mixed together, or any other cases of diseases mixed together. However, further research is warranted to confirm the reported association as this analysis is limited by the low-quality and observational nature of the included studies.

Comparative analysis of cyclin-dependent kinase 2 density by immunohistochemistry in lesional versus nonlesional psoriatic skin

Background Psoriasis is a noninfectious, inflammatory, and hyperproliferative skin disorder. Cyclin-dependent kinase 2 (CDK2) is a serine-threonine protein kinase that plays a role in the transition of G1/S, the initiation of DNA synthesis, and the regulation of the S phase exit in the cell cycle. CDK2 is uniformly expressed in healthy human epidermis being located mainly in the cytoplasm and nuclei of basal keratinocytes.Objective To compare the CDK2 density by immunohistochemistry in lesional versus nonlesional psoriatic skin and normal control and to correlate its expression with disease severity.Patients and methods This study was conducted on 30 patients with plaque psoriasis and 20 age-matched and sex-matched controls. Biopsies were obtained from the active plaque (lesional) and nonlesional skin of the patients and normal controls. CDK2 density was assessed by counting immunohistochemically positive nuclei in 1000 suprabasal keratinocytes at ×400 power fields.Results CDK2 was negative in normal control skin (no positive nuclear staining was seen in suprabasal keratinocytes). Meanwhile, the psoriatic group showed diffuse nuclear positivity in suprabasal cells. The density was significantly higher in lesional versus nonlesional skin. CDK2 density in lesional and nonlesional skin showed a statistically significant correlation with Psoriasis Area and Severity Index score (r=0.820 and 0.683, P<0.001 and <0.001, respectively).Conclusion CDK2 density is high in plaque psoriatic epidermis more than in nonlesional and control skin, and this was positively correlated with disease severity. It indicates that it may play a role in the development of psoriasis and may be a potential therapeutic target.

Mitochondrial dysfunction: The pathological link between psoriasis and insulin resistance?

Psoriasis is strongly associated with insulin resistance (IR). Lipid profile disturbances and upregulation of enzymes crucial for fatty acid oxidation have been reported in patients with psoriasis. Mitochondrial ß-oxidation is altered in patients with IR. Common mitochondrial dysfunction may be involved in the origin of both diseases. This study aimed to evaluate mitochondrial ß-oxidation, intermediary metabolism, and mitochondrial content in psoriatic patients with or without IR and compare them to healthy controls. The participants were divided into three groups: (1) psoriasis and IR (n=26); (2) psoriasis without IR (n=17); and (3) healthy controls (n=17). Quantification of amino acids and acylcarnitines (AC) by tandem mass spectrometry, determination of urinary organic acids by gas chromatography/mass spectrometry (GC/MS), and mitochondrial DNA quantification were performed in all groups. When comparisons were made between the two psoriatic groups, no differences were found between: C5DC + C6OH, C16:1, Met/Leu, Met/Phe, C16:1/C16, and C5DC + C6OH/C4DC + C5OH ratios. Nine analytes were different: phenylalanine, Cit/Phe, and Cit/Tyr ratios, C0, C3, C5, C6DC, C16, and C18:1OH. There were no correlations between psoriasis area and severity index (PASI), body mass index (BMI) and duration of disease with ACs. A higher proportion of patients with psoriasis showed increased urine levels of uric acid and hippuric acid (p=0.01). The mtDNA content was significantly higher in cases than in controls, with no differences between IR and non-IR psoriatic patients. Psoriasis patients with and without IR have a different acylcarnitine profile reflecting impaired ß-oxidation. A distinctive profile of acylcarnitines suggests an involvement of mitochondrial function associated with an increase in stearoyl CoA desaturase (SCD) activity in psoriatic patients with and without IR.

A Study of Serum Uric Acid Level in Patients with Psoriasis at a Tertiary Care Hospital in Eastern Nepal

Background: Meta-analysis has shown that psoriasis is associated with hyperuricemia and its sequel. So this study was done with objective to find out the association of serum uric acid level in patient with psoriasis and its correlation with severity of the disease.&#x0D; Materials and Methods: It was a prospective case control study conducted in the department of Dermatology, Nobel Medical College Teaching Hospital in eastern region of Nepal over a period of one year from Jan 2020 to Dec 2022 after approval of Intuitional review committee on Nobel Medical College Teaching Hospital. The diagnosis of the disease for the cases were done by clinical examination and biopsy when needed. 50 cases and 50 control sample were taken for the study. Psoriasis Area Severity Index was calculated for the cases and serum uric level was measured for both cases and control.&#x0D; Results: The mean serum uric level in psoriatic patients was 6.16 ± 1.64mg/dl with range of 4 to 11 mg/dl and that of control group was 5.39 ± 1.60 mg/dl with the range of 2 to 9mg/dl. Mean serum uric acid level in psoriatic group was significantly higher than in control group with p value of 0.002 and there was positive correlation between severity of psoriasis with serum uric acid level(p=0.001).&#x0D; Conclusion: Psoriasis was associated with hyperuricemia in psoriasis patients.

Abstract 194: Impact Of Psoriasis On The Outcomes Of St-elevation Myocardial Infarction From The Nationwide Readmission Database

Background: Psoriasis is a chronic inflammatory disease which causes atherosclerosis. There is conflicting data regarding the association between psoriasis and the development of cerebrovascular diseases with increased mortality. There is also limited data about the outcomes of the psoriatic patients presenting with ST-elevation myocardial infarction (STEMI). Methods: We queried the Nationwide Readmissions Database (years: 2016-2019) using ICD-10 codes for patients with a primary diagnosis of STEMI who underwent primary percutaneous coronary intervention (PCI). Patients were classified into two groups according to the presence of psoriasis. Outcomes included in-hospital mortality, index admission compilations, 90-day readmission rate, and causes of readmissions. Results: A total of 52,796 patients with STEMI underwent PCI including 308 with psoriasis and 52,488 with no psoriasis. Mean age and gender were similar between both groups. Psoriasis patients had more prevalence of obesity, diabetes mellitus (DM) obstructive sleep apnea (OSA) and depression. In-hospital mortality rate was not significantly different between the two groups. The length of stay and the total charges were higher in the psoriasis group (Table 1). During the index admission, the most common complications were not different. However, hemorrhagic anemia was higher in the psoriatic group. There were 6,896 (13.1%) readmission in the non-psoriasis group compared to 28 (9.1%). Conclusion: Patients with psoriasis had higher prevalence of cardiovascular risk factors including obesity, OSA, and DM, without a significant increase in the in-hospital mortality and the 90-day readmission rate.

Drug Delivery through the Psoriatic Epidermal Barrier-A "Skin-On-A-Chip" Permeability Study and Ex Vivo Optical Imaging.

Psoriasis is a chronic inflammatory disease with unmet medical needs. To clarify potential therapeutic targets, different animal models have been developed. In the current study, imiquimod-induced psoriasiform dermatitis was used for monitoring the changes in skin thickness, transepidermal water loss, body weight, blood perfusion and drug permeability for a topical cream formulation of caffeine, both in wild type and in knock out mice. Morphological characterization of control and diseased tissues was performed by scanning electron microscopy and two-photon microscopy. The chemically induced psoriatic group showed increased skin permeability for the model drug during disease progression. In wild type and TRPA1 KO mice, however, enhanced skin thickness and hyperkeratosis blocked further increase of drug penetration at the late phase (96 h). These results indicate that topical drug therapy can be more effective in early phases of plaque development, when skin thickness is lower. Although paracellular connections (tight junctions) are looser in the advanced phase, hyperkeratosis blocks drug delivery through the transappendageal routes. Novel drug formulations may have the potency for effective drug delivery across the epidermal barrier even in the advanced phase. For development of more effective topical drugs, further research is proposed to explore drug penetration both in healthy and diseased conditions.

Assessment of angiotensin converting enzyme gene polymorphism in patients with psoriasis

Psoriatic patients had diversity of clinical presentations and complications. Psoriasis can have significant interference with the patient's quality of life, recovery, and outcome. Some evidences suggest that the angiotensin converting enzyme (ACE) is present in the skin of psoriatic patients. This study intended to assess the patterns of ACE insertion/deletion (ACE ID) polymorphism and the levels of serum ACE among psoriatic patients in comparison to normal controls. The study included two groups: 20 patients with psoriasis and 20 apparently healthy adults with negative family history of psoriasis as a control group. Psoriasis area and severity index (PASI) was used to measure of severity of psoriasis. In both groups, ACE ID gene polymorphism was assessed by quantitative real-time polymerase reaction and serum ACE levels was evaluated using an enzyme-linked immunosorbent assay. ACE ID genotype was significantly higher among the psoriatic group in comparison to the control group (40.0% versus 15.0%, respectively, p=0.016). D allele was significantly higher among the psoriatic group than the control group (25.0% versus 7.5%, respectively, p=0.034). ACE ID genotype carried significantly higher risk in psoriatic group versus control group (OR=3.8). The D allele carried higher risk in psoriatic group versus control group (OR=4.1). ACE serum levels were significantly higher among the psoriatic group compared to the control group (87.4±7.03 versus 2.3±0.7, respectively; p < 0.001). We concluded that ACE ID gene polymorphism may be considered as a risk factor for developing psoriasis.

Prevalence of Atherosclerosis in Psoriatic Patients Detected with Epiaortic Color Doppler Ultrasound and Computed Tomography Angiography.

IntroductionPsoriasis (PsO), a chronic inflammatory, multisystemic, and multifactorial disease can cause endothelial dysfunction, artery calcification, and atherosclerotic disease. A higher incidence of vascular occlusive events has been observed in psoriatic patients compared to healthy controls, and multiple studies confirm the association between moderate-severe PsO and atherosclerosis, coronary artery calcification, and higher cardiovascular risk.ObjectiveWe sought to analyze atherosclerotic disease prevalence in epiaortic vessels of psoriatic and non-psoriatic patients to understand if PsO could represent an independent risk factor predisposing to atherosclerotic disease.MethodsWe evaluated 47 psoriatic patients without cardiovascular risk factors with color Doppler ultrasound (CDUS). If atheromatous plaques were detected, a computed tomography angiography (CTA) was performed. We evaluated 47 non-psoriatic patients without cardiovascular risk factors with CDUS. Atherosclerosis prevalence in both groups were statistically analyzed. CDUS performance was compared to CTA.ResultsIn the psoriatic group (mean age 50.9 years), 6 had atheromatous plaques and 12 had an intima-media thickness (IMT) > 1 mm (overall prevalence of atherosclerotic disease: 38.2%). All plaques detected with CDUS were confirmed at CTA. In the control group (mean age 51.3 years), CDUS revealed atheromatous plaques in 4 patients and IMT > 1 mm in 4 ones (overall prevalence of 17%). The difference of atherosclerotic disease prevalence between the groups was statistically significant (P < 0.05).ConclusionOur results highlight that PsO could be considered a predisposing factor for atherosclerotic disease development in epiaortic vessels, as it causes an increased IMT, that is also considered an independent cardiovascular risk factor.

Screening for Comorbid Cardiovascular Risk Factors in Pediatric Psoriasis Among Iraqi Patients: A Case-Control Study.

Background: Psoriasis is a polygenic multifactorial immune-mediated skin disease associated with comorbidities. As one-third of adult psoriasis starts during childhood, early detection of these comorbidities might help to mitigate their impact on future health.Objectives: To investigate the risk for cardiovascular events and their relationship with psoriasis severity among Iraqi children and adolescents.Patients and methods: A prospective, case-control, cross-sectional study on 150 patients with psoriasis and 150 age and sex-matched individuals. The study was carried out at the Department of Dermatology/Basra Teaching Hospital from December 2018 to December 2020. Psoriasis severity was assessed by PASI (psoriasis area severity index) score, and in both groups, blood pressure and body mass index (BMI) were measured. Laboratory tests including fasting blood sugar (FBS) and lipid profile were also done.Results: More patients were overweight and obese in the psoriatic group compared to the control group (26.7% and 40% versus 11% and 8%), 5.3% of psoriatic patients who had stage 2 hypertension (defined as any blood pressure [BP] measurement higher than 99th plus 5 mm of mercury applied to BP levels for boys and girls by age and height percentile charts), none of the control group was hypertensive, and the difference was statistically significant (p-value<0.05). A significantly higher proportion of the psoriatic patients had abnormal lipid profiles compared with the control group, 62% versus 30% (p<0.05), 15.3% versus 6.7% had elevated cholesterol (p<0.05), 24.7% versus 8% had raised low-density lipoprotein (LDL, p<0.05), 18% versus 8.6% had low high-density lipoprotein (HDL, p<0.05), and 12.6% versus 6% had elevated very-low-density lipoprotein (VLDL) and triglyceride (TG, p<0.05), 8% patients had elevated FBS (more than 100 mg per deciliter) versus 2.6% (p<0.05), and metabolic syndrome in 65 versus 2% (p<0.05). These changes were related to the severity of psoriasis.Conclusions: Pediatric psoriatic patients in our population may have an atherogenic lipid profile with an increased prevalence of risk factors for cardiovascular diseases, especially those with moderate to severe psoriasis.

Nailfold capillaroscopy in psoriatic domains according to Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)

Introduction Psoriasis and psoriatic arthritis (PSA) are chronic immune-mediated diseases associated with chronic low-grade systemic inflammation, leading to endothelial cells proliferation and vascular insufficiency, which lead to abnormalities in capillaries. Aim To assess the patterns of nailfold capillaroscopy in psoriatic domains and compare these patterns with control groups. Patients and methods A total of 150 patients with psoriasis and PSA were subdivided into five subgroups: group 1 included 30 patients with predominant peripheral PSA; group 2 included 30 patients with predominant peripheral PSA and/or dactylitis, as well as enthesitis; group 3 included 30 patients with predominant axial affection; group 4 included 30 patients with predominant axial affection and/or dactylitis, as well as enthesitis; and group 5 included 30 patients with predominant skin and/or nail affection. In addition, group 6 was the control group, which included 25 patients with rheumatoid arthritis, and group 7 included 25 patients with systemic sclerosis. Results Capillary density was statistically significantly lower among group 7 and higher among group 5. Tortuous capillaries were statistically significantly higher among group 2. However, group 5 had the least tortuous capillaries. Microhemorrhage, angiogenesis, and subpapillary venous plexus were statistically significantly higher among group 7. However, there was no statistically significant difference among the psoriatic groups regarding microhemorrhage, whereas angiogenesis was statistically significantly lower among group 5. Conclusion PSA showed low capillary density, increased tortuous capillaries and capillary hemorrhage, more visibility of subpapillary venous plexus, and dilated capillaries in comparison with patients with rheumatoid arthritis, whereas systemic sclerosis had specific pattern.

The effect of Psoriasis on Female Sexual Function

Background: Psoriasis is one of the most common immune-mediated chronic inflammatory skin disorders. Sexual dysfunction in psoriasis is influenced by factors such as the severity of psoriasis, psoriasis body area and associated physical and/ or psychic comorbidities. Objective: The study aimed to assess female sexual dysfunction and their correlation with psoriasis severity. Patients and Methods: The present study was conducted on two groups: patient group that included 30 female patients with psoriasis, with age ranged from 20-60 years old and control group included 20 healthy females, with matched age. The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) score. Female sexual function was assessed by female sexual function Index (FSFI). Results: The mean of all six FSFI domains were lower in psoriatic group than in control group except pain was increased and with no statistically significant difference between both groups. Orgasm was found to be significantly decreased in female patients with psoriasis than control group. There was a significant negative correlation between female sexual function index (FSFI) and psoriasis severity (PASI). There was a significant negative correlation between age and FSFI among control group. In contrast to psoriasis group, there was no correlation between FSFI and either age or duration of disease. Conclusion: There was asignificant negative correlation between FSFI and PASI.

Audiological evaluation in patients with psoriasis

Background Psoriasis is a multisystem, immune disorder driven by inflammatory processes, characterized by skin and joint manifestations, and may be associated with hearing loss. Aim To assess the hearing function in patients with psoriasis and if psoriasis could cause sensorineural hearing loss (SNHL). Patients and methods A total of 50 patients with psoriasis and 50 apparently healthy controls matched for age and sex were included in a cross-sectional comparative study between May 2017 and April 2018. Medical history of patients was taken. Demographics, type of psoriasis, and disease severity evaluated by PASI score were assessed. All patients who were included in this study provided a complete history and audiological history. All patients underwent otoscopic examination, pure tone audiometry, speech audiometry, and immittancemetry including tympanometry and acoustic reflexes. Results There was no statistically significant difference in age or sex for patients with psoriasis and the control group. Eight patients with psoriasis showed impaired hearing function with significant longer duration with psoriasis and older age more than 20 years old in comparison with the rest of the patient. Conclusion Psoriasis is a chronic inflammatory immune-mediated skin disease with estimated prevalence in Upper Egypt at a rate of 0.19% of skin diseases. There were eight (16%) patients who had SNHL in psoriatic group in comparison with three (6%) cases in nonpsoriatic group. There was a statistically significant difference for the age and the duration of psoriasis in relation to hearing loss. SNHL increased with age in psoriatic patients much more than in healthy controls.

TGF-β1 Gene Polymorphism and Its Correlation with Serum Level of TGF-β1 in Psoriasis Vulgaris Among Iraqi People.

PurposeMany cytokines have been implicated in the pathogenesis of psoriasis, among these the transforming growth factor-beta 1 (TGF-β1) can be endorsed by different mechanisms besides inhibiting keratinocytes proliferation. The role of genetic polymorphisms of TGF-β1 has been studied in various inflammatory diseases. Our aim is to study the correlation of TGF-β1 gene polymorphism at codon 10 and 25 with the expression of serum level of TGF-β1 in a sample of Iraqi psoriatic patients compared to the control group.Materials and MethodsA cross-sectional study involved 100 patients with psoriasis vulgaris and 50 sex- and age-matched healthy volunteers as control group. Serum and genomic DNA were prepared from peripheral blood samples. Amplification refractory mutation system–polymerase chain reaction technique (ARMS-PCR) had been applied for genotyping TGF-β1 codon 10 [rs1982073] and codon 25 [rs1800471] genetic polymorphisms. Enzyme-linked immunosorbent assay technique (ELISA) based on the sandwich principle was used for quantification of serum TGF-β1 level. Psoriasis Area and Severity Index (PASI) scoring was applied for determining the severity in psoriatic patients and classified accordingly to mild (PASI<7), moderate (PASI 7–12), severe (PASI>12) groups.ResultsStatistically significant difference was found in TGF-β1 gene polymorphism between psoriatic patients and control group at codon 10 (T869C) polymorphism (p=0.021) and codon 25 (G915C) polymorphism (p=0.040). No significant association was detected with the mean serum TGF-β1 level, severity of the disease, disease onset, gender, history of psoriatic arthritis, and smoking in both codons. Significant lower mean serum TGF-β1 level was found among psoriatic group (192.17 ± 531.12 ng/L) compared with controls (565.89 ± 1372.30 ng/L) (p = 0.018). Relation of mean serum TGF-β1 level with the onset of the disease was statistically significant (p = 0.004), early-onset disease group was lower (105.92 ± 68.02 ng/L) compared with the late-onset disease group (450.92 ±1027.79 ng/L). The mean serum TGF-β1 level showed no significant differences with the severity of psoriasis, gender, history of psoriatic arthritis, and smoking.ConclusionIraqi population showed a significant association between TGF-β1 gene polymorphism at codon 10 and 25 were with psoriasis susceptibility, and a significantly lower mean serum TGF-β1 level was detected in psoriatic patients.