الفهرس 
Subjects and Methods.Only 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic, relapsing, immune- mediated inflammatory skin disease affecting 1-3% of the world population. Clinical manifestations of psoriasis are heterogeneous, ranges from limited to extensive disease. The majority of patients approximately (80%) have limited disease while approximately (20%) have extensive disease. The most characteristic lesions consist of red, scaly sharply demarcated, erythematous papules and plaques present particularly over extensor surfaces and the scalp. The disease is variable in extent, duration and periodicity of flares.
The etiology of psoriasis is unknown, but evolving evidence suggests that it is a complex disorder caused by interaction of multiple factors includes immunological, environmental and genetic factors.
With the introduction of recent developments in understanding the role of inflammation in the pathogenesis of psoriasis, it is widely believed that psoriasis is not just a skin disease but a systemic inflammatory process.
Ghrelin is a 28-amino acid peptide hormone secreted mainly by the mucosa of the stomach it acts as a critical factor in a variety of physiological and disease processes, including neurogenesis, tumorigenesis, hypertension and tissue regeneration. The anti-inflammatory function of ghrelin has been extensively studied. However, ghrelin may act as a pro-inflammatory peptide inducing, rather than reducing, NF-κB expression and proinflammatory; IL-8 secretion. On the other hand, studies have shown that cytokines directly suppress ghrelin synthesis.
The aim of the current study was to evaluate serum level of ghrelin in psoriasis vulgaris and to correlate its level with clinical aspects of that disease.
This case-control study was carried out on 85 subjects; 60 patients with psoriasis vulgaris and 25 age and gender matched healthy subjects as control group.
Cases were selected from Dermatology out patient clinic, Faculty of Medicine, Menoufia University Hospital during the period from February 2018 to June 2018.
All studied cases were subjected to complete history and clinical general and dermatological examination including assessment of PASI score and BMI . Measurement of lipid profile, fasting blood glucose and serum ghrelin levels were performed.
The result of the current work showed:
1- Cholesterol (P = 0.001), TGs (P = 0.044) and LDL levels were significantly elevated in cases than controls (P = 0.001), but HDL level was significantly decreased compared with controls (P = 0.028).
2- Fasting blood glucose was significantly higher in cases than controls ( P = 0.043).
3- Ghrelin in studied cases was significantly higher compared to controls (P <0.001).
4- The mean serum ghrelin level of mild cases of psoriasis was significantly higher compared to moderate to severe cases (P = 0.011).
Summary & Conclusions
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5- There were statistically significant negative correlations between mean serum level of ghrelin and serum cholesterol (r = - 0.33,
P = 0.010) and LDL (r = - 0.27, P =0.034) levels of the studied cases.
6- The ROC curve analysis of ghrelin for diagnosis of psoriasis in psoriatic patients showed that ghrelin is a good positive test for early detection of psoriasis.