الفهرس 
PsoriasisOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic inflammatory skin disease mostly characterized by red, scaly, sharply demarcated, indurated plaques, commonly affecting the scalp, trunk, elbows, knees and genital areas but can affect any part of the body including nails.
T-cells play a key role in the pathogenesis of psoriasis. Increased levels of proinflammatory cytokines have been found in psoriatic lesions, predominantly of the T helper 1 cell profile. TNF alpha is one of the most potent proinflammatory cytokine prevalent in psoriatic lesions. TNF-alpha has many effects in the induction of an inflammatory response such as stimulation of adhesion molecules (sE-selectin, sP-selectin, sICAM-1). P-selectin and E-selectin are adhesion molecules which are expressed on the endothelial cells and are responsible for leukocyte recruitment.
Soluble E- selectin is regarded as an adequate marker of endothelial activation and suppresses leukocyte migration by competing with surface-associated E-selectin, and can activate neutrophils and act as a proinflammatory agent.
Phototherapy such as NB-UVB therapy has become one of the most commonly used modality for the treatment of a variety of skin diseases including psoriasis.
The aim of this work is to evaluate the role of E-selectin in the pathogenesis of psoriasis, to determine the effect of NB-UVB therapy on serum E-selctin in patients with psoriasis and to determine the relationship between serum E-selectin and disease activity after such treatment. Seventy subjects; 35 patients with plaque psoriasis and 35 age and sex matched healthy controls were included. Each patient was subjected to a detailed history taking and examination. Blood samples were taken from all subjects to assess serum level of E-selectin by ELISA technique before and after treatment. NB-UVB treatment sessions were given for the patient group three times per week for 3 momths. Serum E-selectin levels and PASI scores were measured at the beginning of the study and after 3 months of treatment.
In the present study serum E-selectin levels in the patient group were significantly greater than those of controls, in addition; serum E-selectin levels decreased markedly in a statistically significant manner after NB-UVB therapy in patients with psoriasis in comparison to pre-treatment levels.
Patients with psoriasis have elevated levels of pretreatment and post treatment serum E-selectin in comparison to controls with significant reduction of mean serum E-selectin level and PASI scores after NB-UVB. There was a highly significant correlation between serum E-selectin level and PASI scores among patients with psoriasis before and after treatment.