C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy

J Eur Acad Dermatol Venereol. 2010 Jul;24(7):789-96. doi: 10.1111/j.1468-3083.2009.03527.x. Epub 2009 Dec 11.

Abstract

Background: Psoriasis vulgaris is a chronic recurrent inflammatory skin disease and psoriatic lesions have shown leucocyte infiltration.

Objectives: We aimed to study C-reactive protein (CRP) and leucocyte activation markers/inhibitors as potential monitors of psoriasis vulgaris.

Methods: A cross-sectional (n = 73) and a longitudinal study (before, at 3, 6 and 12 weeks of therapy; n = 47) was performed; 10 patients started topical treatment, 17 narrow-band ultraviolet light B (NBUVB) and 20 psolaren associated to UVA (PUVA); psoriasis severity was defined by Psoriasis Area and Severity Index (PASI).

Results: Compared with control (n = 38), we found higher CRP levels, total leukocyte/neutrophil count, elastase, lactoferrin and alpha1-antitrypsin. Increasing PASI was linked to increasing CRP and a trend to higher elastase and lactoferrin, suggesting that worsening enhances inflammatory response with neutrophil activation. CRP correlated with PASI, total leucocytes, neutrophils, elastase, lactoferrin and alpha1-antitrypsin. NBUVB and PUVA presented similar effects.

Conclusion: We propose CRP as a useful marker of psoriasis severity that could be used to monitor psoriasis and its treatment, and, together with PASI and elastase, could also be used as a global index of severity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood*
  • C-Reactive Protein / metabolism*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Dermatologic Agents / therapeutic use
  • Female
  • Humans
  • Leukocytes / immunology*
  • Longitudinal Studies
  • Lymphocyte Activation*
  • Male
  • Middle Aged
  • Photochemotherapy
  • Psoriasis / blood*
  • Psoriasis / therapy
  • Severity of Illness Index
  • Young Adult

Substances

  • Biomarkers
  • Dermatologic Agents
  • C-Reactive Protein