Study of prognostic markers in psoriasis

Elevated peripheral blood neutrophil counts have been reported in untreated patients with psoriasis [Ps] in absence of infection. Several studies reported high level of white blood cell [WBC] activation products including oxygen inetabolites in the peripheral blood of these patients which in turn trigger an up-regulation of antioxidant defences. The aim of this work was to determine some inflammatory and antioxidant markers which are easily evaluated and can be used as indicators of prognostic significance in Ps. The study was carried out in 40 patients with posriasis vulgaris: 20 patients with mild Ps and the other 20 patients with severe disease. Twenty normal individuals were studied as a control group. We evaluated the following: total and differential leukocytic count and elastase as markers ofneutrophil activation; erythrocyte sedimentation rate [ESR] and c-reactive protein [CRP] and fibrinogen as markers of inflammation; and ceruloplasmiri and transferrin as endogenotis antioxidant markers. The data of this work pointed to the central role of neutiophils in the inflammatory response in Ps. The worsening of the disease accompanies the increase of the inflammatory response of neutrophils. So, values of elastase, CRP and neutrophil counts can be used as parameters for prognosis and worsening of Ps

Soluble interleukin-2 receptor in patients with vitiligo

Vitiligo is a hypopigmentary dennatosis of probable autoiminune origin. The disease may be the consequence of an autoimmune response of cytotoxic T lymphocytes against melanocyte antigens. The measurement of soluble interiuekin-2 receptor [s IL-2R] in serum has been shown to be useful in monitoring, in vivo, the immune activation, and the elevation of sIL-2R is correlated with T cell mediated immune diseases. In order to study the role of sIL-2R in the pathogenesis of vitiligo, the level of sIL-2R was measured in the serum of 39 patients with vitiligo and 20 normal controls using the method of sandwich ELISA. The patients were divided according to the type of the disease into 3 groups; generalized type [19 patients], focal type [12 patients] and segmental type [8 patients]. There was a highly significant increase in sIL-2R level in patients with vitiligo [414.8 +/- 115.1 U/ml] compared with that of the controls [274.36 +/- 30.1 U/ml, P = 0.0001]. There was no significant difference among sIL-2R levels according to sex, either in patients with vitligo or controls. According to the clinical types of vitiligo, sIL-2R levels in generalized and focal types showed highly significant results compared to the control group, while in the segmental type, the level of sIL-2R was not highly significant as the other two types. As regards to the activity of the disease there was a highly significant difference [P = 0.0001] of sIL-2R level between the patients with progressive vitiligo lesions in relation to patients with stable lesions. As regard to the duration of the disease, there was a highly significant increase of sIL-2R levels in patients of less than one year duration [P =0.001] compared to the patients with vitiligo of more than one year duration. From the results of this study, it was noticed that the level of sEL-2R was significantly increased in generalized and focal types of vitiligo than the segmental type and this indicates that the activation of T lymphocytes would be an important component in the pathogenesis of the former 2 types of vitiligo. Also, the results showed that assessing sIL-2R may be significant in estimating the progression of the disease

Hepatitis C virus and hepatitis G virus infection in patients with chronic urticaria

In order to study the prevalence of hepatitis C virus [HCV] and hepatitis G virus [HGV] infection in patients with chronic urticaria, 46 patients with chronic urticaria [25 females and 21 males with mean age of 36.2+10.9 years] were screened for HCV and HGV infection using PCR technique. None of the patients had a history of acute hepatitis. A control group composed of 50 apparently healthy subjects [age and sex matched and from the same geographical region] was included in the study. HCV RNA was detected in 13 out of 46 patients [28.2%] and in 7 out of 50 control subjects [14%], the difference was statistically significant P<0.05]. There was no difference in sex between the positive and negative HCV patients but positive patients were older and the duration of their urticaria was longer and had higher levels of liver enzymes in comparison to HCV negative patients. HGV RNA was detected in 5 out of 46 patients [10.8%] and in 5 out of 50 control subjects [10%], there was no statistical difference between the two results [P>0.05]. From the results of this study, it could be concluded that there is a significant association between HCV infection and chronic urticaria, and that HGV infection has no role in the pathogenesis of chronic urticaria. Thus it is recommended to screen patients with chronic urticaria, especially the older ones with long duration of urticaria and with elevated liver enzymes, for HCV infection, in order to diagnose the disease early. This early diagnosis of HCV infection is important for early treatment

efficacy of systemic versus topical corticosteroids in the treatment of vitiligo patients

Thirty vitiligo patients were submitted to this study and divided into two groups each of them included 15 patients of different types of vitiligo. Group [A] was treated with systemic injectable corticosteroids and group [B] was treated with topical corticosteroids. The results were evaluated after 6 months of continued therapy. We found that corticosteroids either systemic or topical could have a role in treatment of vitiligo but systemic therapy was superior to topical therapy

Soluble interleukin-2 receptor in patients with vitiligo: relation to types, activity and duration of the disease

In order to study the role of soluble interleukin-2 receptor [sIL-2R] in pathogenesis of vitiligo, its serum level was measured in serum of 39 patients with vitiligo and 20 normal controls using the method of sandwich ELISA. The patients were divided according to type of disease into three groups. There was a highly significant increase in sIL-2R level in patients with vitiligo compared with that of the controls. There was no significant difference among sIL- 2R levels according to sex either in patients with vitiligo or controls. It was noticed that the level of sIL-2R was significantly increased in generalized and focal types of vitiligo than segmental type, which indicated that activation of T-lymphocytes would be an important component in pathogenesis of the two types of vitiligo