الفهرس 
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Abstract
Psoriasis is a common, chronic, relapsing disorder that has been reported in 2% of worldwide populations. The plaque psoriasis is the most common clinical type. The typical skin change (primary lesion) is a well defined erythrosquamous plaque; it appears reddened as a clinical sign of inflammation and scaly as a sign of hyperproliferation. Successive removal of the scales shows small bleeding points (Auspitz’ sign) as a sign of angiogenesis in the dermal papillae. The exact pathogenesis of psoriasis is still not fully explained. However, abnormal epidermal differentiation, hyperproliferation and angiogenesis are common histopathological changes in psoriasis. The epidermal proliferation shows great acceleration of transit time of cells from basal cell layer to the uppermost row of squamous cell layer from approximately 53 days in normal epidermis to only 7 days in psoriasis. Labeling of ki-67 is a useful way to demonstrate the proliferative capacity of any tissue. GLUT-1 is one of the most important glucose transporters that facilitates the transport of glucose across the plasma membranes of mammalian cells. Previous studies indicated that upregulation of GLUT-1 contributed to improve glucose metabolism which was connected with rapid proliferation of different tumors. The current study aimed at evaluation of GLUT-1 and Ki-67 expression in involved and uninvolved skin of psoriatic patients in comparison to normal skin to throw light on the role of these molecules in pathogensis of psoriasis. The study was carried out on 30 psoriatic patients and 10 control from outpatient Clinic, Dermatology Department, Faculty of medicine, Menoufiya University. Two skin biopsies were taken from the patients one from involved skin and the other from uninvolved skin. The biopsies were sent to Pathology Department, Faculty of Medicine, Menoufiya University where they were subjected to routine tissue processing ending with paraffin embedded blocks formation. from each block 3 sections were cut, one was stained for haematoxylin and eosin for evaluation of histopathological parameters such as acanthosis, parakeratosis,
angiogenesis and inflammation. Other sections were cut on poly L
lysine slides that were stained immunohistochemically by GLUT-1
and Ki-67 antibodies.
The age of the affected psoriatic patients ranged between 20 and 65
years with a mean of 41.97 ± 13 years and a median of 40.5 years.
The male to female ratio was 1.5:1 and the PASI score of the patients
ranged between 3.6 - 35.8 with a mean of 16.3 ± 8.1 and a median of
14.3.
GLUT-1 was not expressed in normal skin but it was highly
expressed in involved skin (86.7%) of psoriatic patients with mild
degree of intensity in (6.7%), moderate in (43.3%) and strong in
(36.7%) of cases. Uninvolved skin showed GLUT-1 expression in
(76.6%) of cases with mild intensity.
There was a highly significant difference between involved
psoriatic skin and uninvolved psoriatic skin as regards intensity
(P=0.001) and localization of GLUT-1 expression (P=0.001). Also
there was a highly significant difference between involved psoriatic
skin and uninvolved psoriatic skin compared to normal skin
(P=0.001) as regards positive versus negative expression of GLUT-
1.
The study of Ki-67 expression showed that the epidermis of all
normal skin showed nuclear expression of Ki-67 expression in a
percentage ranged between 5 and 70% with a median of 10%. The
epidermis of uninvolved skin of psoriatic patients showed nuclear
Ki-67 expression in a percentage ranged between15 and 80 % with a
median of 50% while the epidermis of all psoriatic involved skin
showed Ki-67 expression in a percentage ranged between 5 to 90 %
with a median of 56%. The Ki-67 expression in psoriatic lesions
showed nuclear and nucleolar localization in 26.7%, nuclear only in
16.7% and nucleolar only in 56.7% of cases.
The current study showed high percentage of Ki-67
expression in both involved and uninvolved skin of psoriasis, while
both were significantly higher (P=0.001) than that of normal skin.
Nucleolar pattern of ki-67 expression which is an indicator for
increased activity of proliferation was significantly associated with
male gender (P= 0.05), marked parakeratosis (P=0.01) and marked
angiogenesis (P=0.05).
There was a tendency of increased GLUT-1 expression with
increased proliferation manifested by higher intensity of GLUT-1
expression with increased degree of acanthosis and with higher
percentage of Ki-67 expression.