psoriasis

The skin is one of the most tangible organs involved in social interactions throughout life. It responds to emotional stimuli. Considering the important role of personality traits and body image in the occurrence of psychosomatic diseases,

It was necessary to compare personality traits and body image in patients with psoriasis and seborrheic dermatitis.

In this study, 80 patients with psoriasis and seborrheic dermatitis referred to skin clinics of hospitals in Ilam city were considered as the sample size. The data collection instruments in this study included a survey with demographic information, the standard Big Five Personality Factors Questionnaire (NEO-FFI) to examine personality traits, and the Body Image Questionnaire (MBSRQ). After collecting the data, SPSS22 software was used to analyze the information.

The average age of the participants was 31.31 ± 8.8 years. 55% of the participants were single, and the rest were married. 50% of the participants had seborrheic dermatitis, 43.8% had psoriasis vulgaris, and 6.2% had scalp psoriasis. A significant difference was observed in the neuroticism trait among patients in all three groups. There is a significant difference at the 5% significance level among the three groups of patients with seborrheic dermatitis, scalp psoriasis, and psoriasis vulgaris.

Considering the important role of personality traits and body image in the occurrence of psychosomatic diseases, and the impact that skin diseases have on the body and mind of individuals, the effect of skin diseases on mental state includes a wide range of anxiety to abnormal concern in the patient. These psychological characteristics are capable of causing or intensifying the skin disease. Therefore, it is necessary to consider the psychological aspects of these diseases and implement interventions to control their psychological impact on patients.

Psoriasis is a chronic skin disease that usually manifests as white and silver spots on the skin. Because of its anti-inflammatory properties, we investigated the effects of ivermectin (IVM) on imiquimod (IMQ)-induced psoriasis in rats. Fifteen rats were assigned to 3 different groups (n=5 per group): the control group received normal water and food; the psoriasis group, in which psoriasis was induced by topical application of IMQ (1 mg per rat), and treatment group where rats were treated daily with topical IVM-gel (1%) from day 3 to 7. The Psoriasis Area Severity Index (PASI) Score for the entire treatment period was used to assess erythema, silver scale, and skin thickness on the dorsal region of rats, and the spleen-to-body weight index on day 7 was examined. Moreover, histological assessment of skin tissues was performed using fluorescence immunostaining and hematoxylin-eosin (H&E) staining.  The severity of lesions in the ivermectin group was reduced compared to the IMQ group, with a significant decrease in the average PASI scores. The results of fluorescence immunostaining showed that topical administration of IVM-gel reduced inflammation by decreasing Toll-like receptor 4 (TLR4) levels and p65 nuclear factor kappa-B (NF-κB). Furthermore, findings from H&E staining revealed that IVM-gel decreased dermal fibrosis, epidermal thickness, and infiltration of inflammatory cells caused by IMQ.  Based on the obtained results, it can be concluded that IVM-gel can effectively reduce psoriasis lesions due to its therapeutic properties, such as anti-inflammatory effects via targeting TLR4/p65 NF-κB.

Psoriasis is a long-lasting inflammatory skin condition that impacts millions globally. The occurrence of this disorder differs significantly across various areas, resulting from a complex interplay of genetic and environmental influences. In psoriasis, the pathogenesis represents a complex interaction of innate and adaptive immunity that plays a significant role in the disease manifestation process. Many genetic factors predispose to psoriasis, which is considered a polygenic disease. Several genes concerning pathways like NF-κB and PI3K/Akt that modulate the amplification of inflammatory response and keratinocyte dysregulation have been elaborated in the light of their differential expression, susceptibility loci, and polymorphisms. Such genetic insights could open a whole new avenue for precision medicine in which biomarkers and gene-targeting therapies are promising options for personalized treatment. This review emphasizes the need for complex investigations into psoriasis, from molecular mechanisms to clinical manifestations, to bridge the gap between basic research and therapeutic development by furthering the understanding of psoriasis and paving the way for innovative treatments addressing skin lesions and systemic effects.

Human papillomaviruses (HPVs) are members of the Papillomaviridae family, characterized by circular, double-stranded DNA. They exhibit strict tropism, infecting either mucosa or skin. The role of HPV in the etiology of psoriasis remains unclear.

The aim of this study was to determine the presence of alpha human papillomavirus in the skin scrapings of patients with psoriasis and its genotype distributions.

The study employed a cross-sectional design and included 53 psoriasis patients and 47 healthy controls from December 2020 to May 2021. After DNA isolation from skin scrapings, the L1 gene region of HPV was amplified using MY09/11 and GP5 +/6 + consensus primer sequences. The HPV genotypes were determined through direct DNA sequence analysis of polymerase chain reaction (PCR) products.

HPV DNA was detected in 34% of psoriasis patients and 29.8% of healthy individuals. Among the patients, HPV18 was found in 11.1%, HPV31 in 38.9%, and HPV81 in 50%. In the healthy individuals, HPV31 was found in 7.1% and HPV81 in 92.9%. HPV DNA was detected in 31.8% of patients who received psoralen UV-A (PUVA) treatment and 35.5% of those who did not. High-risk (HR) HPV18 was identified in two patients (28.6%) within the group treated with PUVA.

There is a potential risk for psoriasis patients who receive lifelong immunosuppressive treatment in the case of persistent infections with the HR oncogenic types (HPV18 and HPV31) of alpha HPVs identified in this study. The high prevalence of low-risk HPV81 in healthy individuals suggests that alpha HPVs might occur as members of the normal skin flora without causing cutaneous lesions in healthy skin.

There is controversy whether eosinophils are involved  in the pathogenesis of psoriasis. This study aims to assess the quantity of eosinophils in pathological specimens obtained from individuals diagnosed with psoriasis.

cross-sectional and retrospective study 91 skin samples were obtained from patients with diagnosis of psoriasis. Two experienced dermatologists thoroughly reviewed the specimens' demographic characteristics, clinical features, and pathological attributes. Subsequently, eosinophils were counted within all microscopic fields, utilizing a magnification of 200.

 Eosinophils were present in approximately 70.3% of the examined samples, with a mean eosinophil count of 2.42±0.63. Although no significant correlation was observed between the clinical subtype and the average eosinophil count, eosinophils were most commonly detected in the cases presenting generalized pustular psoriasis (100%) and vulgaris types (71.11%). Notably, patients exhibiting Munro's microabscess and dilated papillary dermal blood vessels exhibited a significantly higher number of eosinophils (P=0.007 and P=0.039, respectively). Additionally, a notable association was identified between presence of spongiosis, and eosinophil counts in the pathological samples (P=0.04).

Presence of eosinophils may not contradict a diagnosis of psoriasis. Furthermore, a notable association may be observed between the number of eosinophils and  presence of spongiosis, dilated dermal papillary vessels, and Munro's microabscess.

The exact cause of psoriatic arthritis is still unknown, but hypotheses suggest the role of hematological parameters in the onset and severity of the disease. This study evaluated the hematological indices and their association with skin and joint activity in psoriatic arthritis.This cross-sectional study included 74 patients with psoriatic arthritis. Demographical and clinical data, blood indices, psoriasis area and severity index (PASI) score and disease activity in psoriatic arthritis (DAPSA) scores were calculated for all patients.The mean age of the patients was 48.89±12.03 years and most were female (n=49). A significant correlation was observed between age and number of underlying diseases with PASI and DAPSA scores. Mean PASI and DAPSA scores were 5.19 and 15.13, respectively. The severity of psoriasis was mild in 58.1%, moderate in 36.5%, and severe in 4.5% of the cases. The activity of psoriatic arthritis was improved in 2.1%, low in 55.4%, moderate in 24.3%, and high in 1.8% of the patients. A significant association was found between erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet (PLT) count, mean platelet volume (MPV), and PASI scores, while no statistically significant association was reported for PLR. A significant correlation was observed between ESR, CRP, RDW, NLR, PLR, PLT, and DAPSA scores, while no statistically significant association was found for MPV.
The findings indicated that inflammatory and hematological markers can be helpful factors in evaluating the severity of psoriasis and psoriatic arthritis.

The introduction of the gut-skin axis as a new concept casts light on the complex relationship between dermatological maladies and the human intestinal microbiome. A wealth of evidence now substantiates the crucial involvement of the gut microbiota in the development of psoriasis, emphasizing the need for further exploration in this field. The development of psoriasis involves a combination of factors, making its pathogenesis multifactorial. In addition, psoriasis has been connected to several comorbid conditions. The intricate connection between gut health and skin homeostasis is established through the alteration of immune functions, highlighting the reciprocal nature of this association. This review delves into how an imbalanced gut microbiome can have detrimental effects on psoriasis. Furthermore, this review seeks to discuss potential and emerging therapeutic interventions, encompassing dietary approaches, probiotic supplementation, orally administered engineered bacteria, and phage therapy.

 Psoriasis is a common autoimmune skin disease associated with genetically influenced chronic inflammation accompanied by remitting and deteriorating scaly skin. T-cell targeted biologics, IL-17 inhibitors, IL 12/IL-23 inhibitors, TNF-α inhibitors, PDE4 inhibitors, and ultraviolet (UV) radiation are applied to treat psoriasis. Efficacy evaluation of narrow-band UVB (NB-UVB) radiation was the aim of this study.

 Data were extracted from Gene Expression Omnibus (GEO) and were pre-evaluated via the GEO2R program. The significant differentially expressed genes (DEGs) were included in the protein-protein interaction (PPI) network analysis. The hubs, bottlenecks, and hub-bottleneck DEGs were introduced as central genes. Activation, inhibition, and expression relationship between central genes were assessed to explore the critical individuals.

 Among 513 analyzed significant DEGs, 22 hub-bottleneck genes were identified. Further analysis revealed that FN1, STAT3, HIF1A, IL1B, P4HB, SOD2, MMP2, and STAT1 were the crucial genes in psoriasis samples targeted by NB-UVB radiation.

 In conclusion, NB-UVB radiation as treatment targets critical genes in peri-lesion skin tissue biopsy of psoriasis patients via a complicated mechanism. This therapeutic method downregulates STAT3, HIF1A, IL1B, and P4HB to treat psoriasis but downregulates STAT1 and SOD2 and upregulates MMP2 and FN1 to develop disease.

In topical preparations, four herbal compounds, namely mangiferin (MF), resveratrol (RV), silybin (SB), and curcumin (CR) need to be quantified quickly and accurately.

This study utilizes a Franz diffusion cell setup to evaluate the suitability of reversed-phase ultra-fast liquid chromatography (UFLC) for assessing MF, RV, SB, and CR in a mouse skin.

A C-18 column (250×4.6 mm, 5 µm) was used at 40 °C for chromatographic separation. The mobile phase, a gradient of acetonitrile and 0.1% formic acid in high-performance liquid chromatography (HPLC) grade water was pumped at a rate of 1 mL per min. A 20 µL sample was loaded, and analytes were accessed using a photodiode array  (PDA) detector. The method validation included selectivity, linearity (2-20 µg/mL), accuracy, precision, robustness, and sensitivity. The method’s run time was 20 min.

The UFLC method was selective for the given compounds, and over the concentration range of 2–20 µg/mL, the method’s linearity was demonstrated with a correlation coefficient >0.99. Additionally, it was accurate, precise, robust, and sensitive, with a total run time of 20 min.

The validated reversed-phase UFLC method meets the highlighted need for accurate and quick measurement of MF, RV, SB, and CR in topical formulations. Its effective validation and application in researching drug features using a Franz diffusion cell apparatus make it an important analytical tool in pharmaceutical research, ensuring precise drug content, homogeneity, and release properties in topical formulations.

Psoriasis is an inflammatory skin disease, and the main topical treatment for this disease is corticosteroids, vitamin D analogs, salicylic acid, and calcineurin inhibitors. This study clinically evaluates a topical dosage form of methotrexate (MTX) micro-emulsion and compares it with clobetasol lotion.

The employed methodology involves 20 patients with symmetric psoriasis. Topical MTX micro-emulsion (0.25%) was used on one side and clobetasol lotion (0.05%) on the other side. The psoriasis area and severity index score were used to evaluate the results in weeks 0, 4 and 8.

The average psoriasis improvement and psoriasis area and severity index score reduction using topical MTX micro-emulsion were 47.24%±10.1524% and 73.5%±6.34% at the end of the first and second months of treatment. The results using clobetasol lotion were 56.5%±8.08% and 73.4%±7.27% after the first and second months of treatment, respectively. There was a significant statistical difference between MTX micro-emulsion and clobetasol lotion after the first month of treatment (α=0.005); however, this difference was not significant after the second month (α=0.938).

The application of topical MTX micro-emulsion can be effective in improving psoriasis and is much safer compared to injectable forms.

Psoriasis is a chronic disease that significantly negatively affects a patient’s quality of life. Based on etiopathological characteristics, there is strong evidence of susceptibility to psychological disorders, such as depression and bipolar disorder, in patients suffering from psoriasis.

We investigated the frequency of bipolar spectrum disorders in psoriasis patients compared to healthy controls in a selected population in Iran.

This case-control study was conducted on two sample groups, with and without psoriasis (50 people in each group). The statistical population included all individuals referred to Shohadaye Tajrish and Taleghani Hospitals of Shahid Beheshti University of Medical Sciences, selected using the available method and assigned to two groups in 2023. The participants were examined for the presence of bipolar spectrum disorders using the Mood Disorder Questionnaire (MDQ) and the Bipolar Spectrum Diagnostic Scale (BSDS).

According to the MDQ questionnaire, the frequency rates of bipolar disorder in the patients and controls were 20% and 40%, respectively, with no significant difference between the groups (P = 0.108). Based on the BSDS, the frequency of bipolar disorder in the two groups, with and without psoriasis, was estimated to be 25% and 32.1%, respectively, with no significant difference (P = 0.226). The rate of major depressive disorders was also 22% and 26%, with no significant difference (P = 0.640).

Among Iranian patients with psoriasis, the presence of the disease may not be associated with an increased risk of bipolar spectrum disorders.

Atopic dermatitis (AD) and psoriasis plaque (PP) are chronic inflammatory skin diseases that have a significant cutaneous and systemic disease impact and a poor health-related quality of life. Due to the lack of evidence related to severe AD in humans, this research attempted to identify potential new biomarkers associated with moderate AD. In addition, the interaction between identified genes with known medications was investigated. A meta-analysis was performed on several gene expression profile datasets to identify differentially expressed genes (DEGs) between AD and PP tissue samples and healthy tissue samples. Gene Set Enrichment Analysis (GSEA) was performed using clusterProfiler software. To investigate gene-drug interactions from different resources, the DGIdb online server was employed to construct the gene-drug networks. There were 5 and 91 DEGs between AD and PP compared to normal samples. Each condition yielded four overlapping genes, including GALNT6, IL37, BTC, and OGN. Mucin type O-glycan biosynthesis, other types of O-glycan biosynthesis, and growth factor activity in AD; Hepatitis C and NOD-like receptor, and defense response to symbiont in PP were demonstrated to be statistically significant. The interaction of STAT1, Pdcd1lg2, and CCNB1 genes with known medications was identified. Mild AD may have novel markers GALNT6, IL37, BTC, OGN, and CORIN. CLDN1, REG3A, GBP-1, IRF1, PLSCR1, and STAT1 might be novel markers of PP. AD and PP immune response might be regulated by miR-106b and miR-17.

Psoriasis is a chronic, untreatable and disabling disease. In this research, we investigated the pharmacological properties of Euphorbia milii petroleum ether and ethyl acetate in a psoriasis mouse model. 

Thirty-one albino mice were used in this study. They were divided into five groups: group I, healthy animals; group II, inducer group with imiquimod 12.5 mg (5% cream); and groups III, IV and V were imiquimod-induced and then treated with clobetasol 0.05% in group III, E. milii petroleum ether fraction in group IV and E. milii ethyl acetate fraction in group V. Immunohistochemistry for interleukin-17 (IL-17), vascular endothelial growth factor and transforming growth factor-beta, as well as histopathology were done on the mice skin.

E. milii petroleum ether group showed a significant decrease in skin immunohistochemistry of IL-17, transforming growth factor-beta, and other histopathology parameters, while ethyl acetate fraction showed a significant reduction in vascular endothelial growth factor and other histopathology parameters

E. milii petroleum ether and ethyl acetate fractions may have a role in psoriasis treatment in a mice model.

Psoriasis is an inflammatory skin disease that is complex, chronic, immune-mediated, and has a hereditary basis. Oxidative imbalance is documented in psoriasis, and exposure to ROS is responsible for keratinocyte destruction, leading to pro-inflammatory mediators to be released and recruitment of immune cells, thus, it is possible that CoQ10 therapy may modify the function of oxidative stress, subsequently inhibiting keratinocyte proliferation. The goal of the present study attempts the addition of CoQ10 to biological therapy can help to relieve inflammation from Iraqi patients suffering from moderate to severe psoriasis .

The investigational group involves thirty individuals with moderate to severe psoriasis were divided into (2) groups at random: Fifteen psoriatic patients received treatment with 40 mg of Adalimumab twice a month for a period of twelve weeks in Group A. Similarly, fifteen psoriatic patients received treatment with 40 mg of Adalimumab twice a month in Group B, along with a daily dose of 100 mg of CoQ10. The percentage improvement changes during the treatment period were assessed using the psoriasis area and severity index (PASI). In addition, serum levels for oxidative stress indicators, including SOD and MDA, were measured before and after therapy using the ELISA technique .

When compared to the patients before treatment, the two groups showed a substantial decline (p<0.05) after treatment; however, group B, which added CoQ10 to biological treatment, showed a highly significant decrease (p<0.05) in mean SOD level and MDA after treatment. Furthermore, following twelve weeks of treatment, group B's use of combined adjuvant therapy showed even greater recovery, as indicated by a 79% PIC PASI score improvement as opposed to a 60% PIC score.

This trail exhibits that addition everyday dose of CoQ10 to biological treatment has additional positive impact on reducing oxidative stress related to psoriasis.

Evidence highlighted the high prevalence of some mental problems among individuals with psoriasis, including alexithymia and suicidal ideation. 

The present study aims to investigate the prevalence and comorbidity of alexithymia and suicidal ideation in individuals with psoriasis in Iran.

This cross-sectional study was conducted on 100 patients with psoriasis referred to Razi Dermatology Clinic and Beesat Clinic of hospitals affiliated to Guilan University of Medical Sciences, Rasht, Iran, in 2020. Psoriasis was diagnosed by a dermatologist, and the demographic and clinical characteristics of patients were recorded. The Toronto alexithymia scale (TAS-20) and the Beck scale for suicidal ideation (BSSI) were used to assess alexithymia and suicidal thoughts. 

The mean age of patients was 37.56±10.58 years, and 51% were female. Among patients, 52% had alexithymia, 23% were at high risk of suicide, and 6% were at very high risk of suicide. The moderate severity of psoriasis had a significant association with suicidal thoughts (P<0.05). The TAS-20 score had a significant association with the male gender and younger age, and the BSSI score had a significant association with the psoriasis area (P=0.003). The highest score of BSSI was seen in those with psoriasis in the face and limb/trunk (10±4.36 and 8.56±8.52, respectively).

Patients with psoriasis exhibit a significant prevalence of alexithymia and suicidal thoughts. Additionally, younger age and male gender were identified as factors associated with alexithymia in this population.