الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 86 |  |  |
| | | from | 86 | | |
Abstract
Psoriasis is a chronic, recurrent, immune-mediated inflammatory disease and is
characterized by epidermal hyperplasia, dilated and prominent blood vessels in the
dermis, and an inflammatory infiltrate of leukocytes, predominantly in the dermis.
It affects 1-3% of the world population and characterized by well-demarcated
erythematous plaques with adherent silvery scales. The most frequent areas of
involvement include the elbows, knees, lower back, and buttocks but the disease can
involve any cutaneous surface. Variations in the morphology of psoriasis have been
classified into several clinical subtypes as plaque psoriasis, guttate psoriasis,
erythrodermic psoriasis, psoriatic arthritis and pustular psoriasis.
The pathogenesis is not known but it is mostly the outcome of interplay between
different factors including genetic, metabolic and environmental triggers.
In humans, uric acid is the final breakdown product of purine metabolism. The
two purines (Adenine and guanine) are sequentially degraded by a series of enzymes to
form xanthine and hypoxanthine. Both compounds are then oxidized by a final enzyme,
called xanthine oxidase to produce uric acid.
Uric acid is a heterocyclic organic compound with the formula C5H4N4O3 (7.9-
dihydro-1 H-purine-2, 6.8 (3H)-trione) and a molecular weight of 168 Daltons.
Increased serum uric acid is accepted as a common finding in patients with
psoriasis. Enhanced purine catabolism due to the increased epidermal cell turnover is
thought to be the cause of the raised serum uric acid. Therefore, a correlation of the
serum uric acid concentration (SUAC) with the extent of skin involvement would be
expected. Hyperuricemia is an abnormally high level of uric acid in the blood. In the pH
conditions of body fluids, uric acid exists largely as urate, the ion form. The amount of
urate in the body depends on the balance between the amount of purines eaten in food,
the amount of urate synthesised within the body (e.g., through cell turnover), and the
amount of urate that is excreted in urine or through the gastrointestinal tract.
The aim of the work is to assess any association between serum uric acid and
clinical features of psoriasis.
This study was conducted at the Dermatology and Medical Biochemistry
Department, Faculty of Medicine, Menoufia University. The study included 100
patients with chronic generalized psoriasis. These patients were collected from
Outpatient Clinic of Dermatology, Andrology and STDs Department, Menoufia
university hospital. In addition to 100 age and gender matched healthy individuals
served as control group.
Subjects of this study were categorized as two groups:
Group1: included 100 psoriatic patients. The diagnosis of psoriasis was based on PASI
score calculation [253].
According to PASI score they were subdivided into 3 subgroups:
group 1a: Included 54 patients with mild psoriasis (PASI<5). They are 28 males and
26 females with mean age ± SD 37.3±13.25 years.
Summary
52
group 1b: Included 39 patients with moderate psoriasis (PASI 5-15). They are 26
males and 13 females with mean age ± SD 40.7±16.65 years.
group 1c: Included 7 patients with severe psoriasis (PASI>15). They are 7 males with
mean age ± SD 37.7±14.95 years.
Group2: Included 100 ages and gender matched healthy subjects served as controls.
All studied subjects subjected to complete history taking, clinical,
dermatological examination including assessment of PASI score, calculation of BMI.
Blood samples were taken for detection of serum uric acid level.
The results of the present study can be summarized as follow:
There is non-significant statistical difference between patient’s subgroups
regarding age and BMI. Whereas significance difference in gender existed.
The number of lesions in the majority of patients in group 1a and 1b is two sites.
In group 1c the majority of patients are affected in three sites. The duration of
disease was less than 10 years in 81.5% in group 1a, 76.9% of group 1b and 85.7
of group 1c. The disease is stable in 96.3% of group 1a patients, 46.2% of group
1b patients. Whereas all patients of group 1c are unstable. There is significant
statistical increase of PASI score in group 1c compared to group 1a and
group1b. Also a significant increase existed in group 1b compared to group 1a.
There is significant statistical increase in serum uric acid in patients compared to
controls.
There is significant statistical increase in serum uric acid in group 1c compared
to group 1b and group 1a.
There is non-significant statistical increase in the serum uric acid level in male
than female patients.
There is non-significant statistical increase in serum uric acid level in patients
with duration of disease more than 10 years than those less than 10 years.
There is significant positive correlation between serum uric acid level and each
of age, duration of disease and PASI score in group 1.
There is significant statistical difference between hyperuricemic (uric acid >7 in
men &6 in women) and normouricemic psoriatic patients regarding site of lesion
and stability. Whereas nonsignificant statistical difference existed regarding
duration of disease and PASI score.