Background: Recent lines of evidence suggest that prolactin (PRL) as a neurohormone may play a role in the activity of psoriasis and some other immune-mediated diseases. Our aim was to evaluate the correlation between serum PRL levels and severity of psoriasis, vitiligo and alopecia areata.Patients and methods: We performed a case-control study on 100 subjects: 75 patients; suffering from psoriasis, vitiligo and alopecia areata; 25 patients in each group and 25 age-and sex-matched healthy controls.Results: Serum prolactin levels were significantly high in all three dermatological diseases in comparison with the control group (P = 0.000). The mean ± SD of the serum prolactin levels was 21.8 ± 11.5 ng/ml, 16.9 ± 6.8 ng/ml, and 16.6 ± 8.0 ng/ml in patients with alopecia areata, psoriasis and vitiligo respectively. Moreover, the serum prolactin levels in patients with alopecia areata and psoriasis were significantly correlated with disease severity (P < 0.05), however no statistically significant correlation was noted between vitiligo severity and serum prolactin levels (P > 0.05).Conclusions: Prolactin may play a role in the pathogenesis of alopecia areata, psoriasis, and vitiligo; and may serve as a biological marker of disease activity in patients with psoriasis and alopecia areata. Ó 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).