الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a common, chronic, and recurrent inflammatory skin
disease of a complex, multifactorial hyperproliferative and T cell-
mediated inflammation. It is a polygenic disease and various triggering
factors, e.g. trauma, infections or medications, may elicit a psoriatic
phenotype in predisposed individuals. The Clinical hallmarks comprise a
sharply demarcated erythematous plaques with silvery white scales, these
scaly red plaques are a clinical reflection of hyperkeratosis, parakeratosis,
acanthosis of the epidermis, tortuous and dilated vessels, and an
inflammatory infiltrate composed primarily of lymphocytes.
Obesity has long been associated with and considered detrimental
for psoriasis. Patients weighing more than their ideal body weight also
tend to have worse psoriasis in terms of the proportion of involved skin,
and the extent of their psoriasis lesions correlates with body mass index
(BMI).
Expansion of adipose tissue during weight gain leads to the
recruitment of macrophages into the adipose tissue, and this is probably
mediated by adipocyte- derived chemokines such as CCL2 (monocyte
chemoattractant protein-1).Macrophages are the chief source of adipose
tissue-derived tumour necrosis factor (TNF)-a and are an important
component of the non-adipocyte fraction of this tissue, which is also the
main source of interleukin (IL)-6 and CXCL8.
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Summary & Conclusion
These cytokines are abundant in psoriasis skin, their levels in
suction blister fluids of involved psoriasis skin correlate with disease
severity and both have established roles in psoriasis pathogenesis.
The risk of psoriasis is directly related to body mass index BMI,
and that patients with obesity are likely to have severe psoriasis. Psoriasis
and obesity share similar mediators of inflammation, mainly tumor
necrosis factor(TNF) and interleukin (IL)-6, and the effectors of
adipocytic and psoriatic inflammation, mainly adipocytes and
macrophages, derive from a common mesothelial origin, the high
circulating leptin levels in individuals with psoriasis may drive not only
from fat tissue but also from inflammation. Body weight loss has been
reported to significantly decrease leptin levels and improve insulin
sensitivity and may reduce the likelihood of developing metabolic
syndrome and adverse cardiovascular diseases so, Body weight loss could
potentially become part of the general treatment of psoriasis, especially in
patients with obesity.
The present study was performed on (38) psoriatic patients
attending to dermatology clinic Suez Canal university, and (38) control
group. All patients were subjected to clinical history taking, clinical and
dermatological examination. PASI score and BMI were calculated and
serum leptin levels were measured by ELIZA technique.
In our study, patients with psoriasis were found to have elevated
serum leptin levels in comparison to normal controls. Moreover, a
significant correlation between serum leptin in psoriatic patients and
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Summary & Conclusion
their BMI was found, whereas no significant correlation between serum
leptin with the disease duration nor severity of psoriasis.
Also, there was no significant correlation between severity of
psoriasis and the disease duration nor BMI .
In conclusion, our study provides further evidence on the
importance of leptin in the pathogenesis of psoriasis based on its
elevation in the serum of psoriatic patients that probably reflects
activation of T cell mediated immuno-pathogenic mechanisms in
response to these elevated levels. Also elevated leptin may play a role in
psoriatic patients due to elevated BMI in these patients, but it is not
contributing to the severity and chronicity of the disease.