الفهرس 
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Abstract
Psoriasis is common chronic inflammatory disease of the skin that causes red, flaky, scaly patches of skin covered with silvery scales. These patches normally appear on elbows, knees, scalp and lower back, but can appear anywhere in the body. Most people are only affected with small patches. In some cases, the patches can be itchy or sore. Elafin is barely detectable in normal skin and is strongly expressed in inflamed skin. It is highly expressed in epidermis, sputum, and urine of psoriatic patients but is not specific for psoriasis. The aim of the current study was to estimate the serum level of elafin in psoriasis cases and its correlation with the severity of psoriasis. This was a case control study carried out on 45 patients with different clinical types of psoriasis, newly diagnosed or who stopped systemic treatment for at least 3 months before the study. They were recruited from the outpatient clinic of dermatology department of Mansoura University Hospital, from August 2018 to August 2019. In addition 45 normal healthy subjects with matched age and sex were selected to act as a control group. The current study revealed that following results : Both groups demonstrated insignificant differences in terms of all demographic and anthropometric parameters. The mean onset, duration and PASI were (37 ± 9.43), (8.37 ± 8.07) and (23.28 ± 14.53) respectively. The majority of the studied cases had psoriasis vulgaris (80%), while only 4.4%, 8.9% and 6.7% had erythrodermic psoriasis, guttate psoriasis and pustular psoriasis respectively. Psoriasis group was associated with a significant increase in ESR level compared to the control group. Psoriasis group was associated with a significant increase in CRP level compared to the control group. Psoriasis group was associated with a significant increase in serum elafin level compared to the control group. Psoriatic smoker cases demonstrated statistically significant increase in serum elafin level compared to non-smokers. Psoriatic cases with positive family history demonstrated highly statistically significant increase in serum elafin level compared to the negative cases. Cases with erythrodermic psoriasis demonstrated the highest level of serum elafin followed by pustular psoriasis, then guttate psoriasis and lastly psoriasis vulgaris. Cases with severe psoriasis demonstrated the highest serum elafin level followed by moderate psoriasis and lastly mild psoriasis. ESR, CRP and elafin demonstrated significant differences in the differentiation among psorisias and the control group. ESR, CRP and elafin could be used as reliable biomarkers in terms of the differentiation among psorisias and the control group with high accuracy, sensitivity and specificity. No significant correlation was detected between elafin and all demographic parameters. Elafin level was demonstrated to be significantly correlated with PASI, ESR and CRP.