Kasr Al-Ainy’s psoriasis unit protocol for the management of psoriasis, part I: topical and systemic therapies

Rasheed, Hoda; El-Moaty, •Hesham Az; El-Komy, Mohamed H.M.; Mashaly, Heba M.; Sayed, Khadiga S; Hafez, Vanessa; El-Mesidy, Marwa S; Said, Eman Raafat; Amer, Medhat; AlOrbani, Aya M; Saadi, Dina G; El‐Kalioby, Mona; Eid, Reem O; Azzazi, Yousra

doi:10.4103/jewd.jewd_8_19

Cited by 1 publication

(1 citation statement)

References 52 publications

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“…However, there are several studies are available dealing with other factors that play roles in the pathogenesis, their correlation to disease severity or treatment of psoriasis. [10][11][12] There are some studies also concerning the different protocols for the management of psoriasis at Kasr Al-Ainy's Psoriasis Unit, Cairo, 13 either topical and systemic therapies or biological therapies. 14 We hypothesized that the inflammatory and hyperproliferative features of psoriasis may be associated with increased levels of CFD that may provide a new inflammatory marker to monitor psoriasis, its severity and treatment in Egyptian patients.…”

Section: Introductionmentioning

confidence: 99%

<p>Circulating Cell-Free DNA as Inflammatory Marker in Egyptian Psoriasis Patients</p>

Anani

Tawfeik

Maklad

et al. 2020

PTT

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Background: Cell lesion and apoptosis with release of cell-free DNA (CFD) in circulation are associated with chronic inflammation of psoriasis. Objective: The objective of this study was to determine the CFD concentrations in sera of patients with psoriasis, to assess its relationship with disease severity as defined by Psoriasis Area Severity Index (PASI) and other inflammatory biomarkers (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) levels, and to monitor the efficacy of treatment. Patients and Methods: Thirty adult patients with different types of psoriasis (25 vulgaris; 10 mild, 15 moderate and 5 erythroderma; severe) were evaluated during the exacerbation phase of the disease, before starting (T0) and after 12 weeks (T12) of treatment with topical therapy for mild cases, narrowband-ultraviolet light B (NB-UVB) for moderate cases and methotrexate for severe cases. Twenty healthy controls were also involved in the study. The concentrations of CFD in sera were measured before and after treatment by quantitative real time PCR (qPCR) using primers of the human β-globin gene. Results: At T0, all patients presented significant higher levels of ESR (P=0.05) and CFD (P=0.001) compared with controls. Highly significant elevations of all parameters were observed in severe disease (erythroderma) compared to mild/moderate disease (vulgaris). Methotrexate treatment induced highly significant reductions in all inflammatory markers including CFD (P= 0.042) while topical and UV irradiation therapies had no effects. CFD concentrations showed positive correlations with both PASI (r=0.422, P=0.020) and ESR (r=0.321, P=0.023) only before the start of treatment. Conclusion: The level of circulating CFD could be used to monitor psoriasis severity. However, its level cannot be stated for the treatment, except in severe erythrodermic patients upon successful treatment with methotrexate. We recommend validation of a convenient and accurate DNA assay applied directly to biological samples which does not require prior DNA extraction and amplification.

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