الفهرس 
PsoriasisOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a chronic, recurrent, immune-mediated inflammatory disease and is characterized by epidermal hyperplasia, dilated and prominent blood vessels in the dermis, and an inflammatory infiltrate of leukocytes, predominantly in the dermis.
It affects 1-3% of the world population and characterized by welldemarcated erythematous plaques with adherent silvery scales.
The most frequent areas of involvement include the elbows, knees, lower back, and buttocks but the disease can involve any cutaneous surface. Variations in the morphology of psoriasis have been classified into several clinical subtypes as plaque psoriasis, guttate psoriasis, erythrodermic psoriasis, psoriatic arthritis and pustular psoriasis.
The pathogenesis is not known but it is mostly the outcome of interplay between different factors including genetic, metabolic and environmental triggers.
The study was interventional study aiming to assess the clinical efficacy of bromocriptine on disease severity in patients with chronic plaque-type psoriasis, assess the influence of serum prolactin levels on disease severity in patients with chronic plaque-type psoriasis and compare between narrow-band ultraviolet B (NB-UVB), bromocriptine and the combined therapy of bromocriptine and narrow-band ultraviolet B (NBUVB) as treatments options for psoriatic patients
This study was carried out on 90 patients presented with chronic plaque psoriasis aged from 18 to 50 years. The patients were enrolled from the inpatients‘ section and out-patients‘ clinics of the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Menoufia University and Shebin Elkom teaching hospital during the period from October 2021 till September 2022. All subjects gave informed written consent to participate in this work. This work is approved by the Menoufia Ethical committee research, Menoufia Faculty of Medicine.
The study included all patients with chronic plaque psoriasis in the selected settings.
Patients were randomly divided into three equal groups:
group I: 30 Patients treated with narrow-band ultraviolet B (NB- UVB) and received three sessions per week for 12 weeks
group II: 30 patients received bromocriptine in a dose of 5 mg/day for 12 weeks.
group III: 30 patients received combined therapy of NB-UVB sessions (three sessions per week) and bromocryptine (in a dose of 5 mg/day) for 12 weeks.
All studied subjects subjected to complete history taking, clinical, dermatological examination including assessment of PASI score. Blood samples were taken for detection of serum prolactin level before and after treatment.
The results of the present study can be summarized as follow:
The mean age of the studied patients was 41.8 , about 70% of them were male ,about 76.5% were working ,48.3% of them were married ,48.3% lived in rural areas and 63.8% were low standard
The mean serum prolactin levels in our patients were on higher side of the normal result revealed existence of correlation between serum prolactin level and PASI score which is statistically significant. Whether prolactin plays any significant role in the pathogenesis of psoriasis, its high serum levels are biological markers of disease activity.
The data suggest that circulating PRL levels may influence the pathogenesis of psoriasis and PRL levels were significantly higher in the psoriasis group, with a correlation coefficient between PRL levels and psoriasis severity.
Significant positive correlation between serum prolactin and each of duration of disease and PASI score.
A poor QoL was substantially correlated with younger age, marital status, and extensive body surface area involved.
The relationship between body surface area and quality of life, finding that a greater BSA involvement was positively correlated with a lower QoL.
Bromocriptine may have a role in the treatment of chronic plaquetype psoriasis in the absence of hyperprolactinemia, and that NBUVB may have an additive effect to bromocriptine on serum PRL levels and on severity of the disease. We did not find bromocriptine alone to be superior to NB-UVB in the treatment of psoriasis.
The study concluded that bromocriptine may have a role in the treatment of chronic plaque-type psoriasis and that NB-UVB may have an additive effect to bromocriptine on serum PRL levels. We found a correlation between serum PRL levels and disease severity.
Recommendations of this study were that patients with psoriasis should be monitored for serum prolactin levels. Follow up of psoriasis patients after bromocriptine treatment regarding clinical and laboratory parameters. The combination of NB-UVB and bromocriptine found to be superior to NB-UVB therapy alone in the treatment of psoriasis.