ABSTRACT
As numerous scientific data show, despite the fact that patients with severe psoriasis have a high risk of coronavirus infection, COVID-19 in this group proceeds quite easily. However, many specialists have encountered an unusual exacerbation of the pso-riatic process already after the infection, the reasons for which may be several. On the one hand, the skin is one of the target organs for SARS-CoV-2, on the other hand, exacerbations may be caused by the immune system response to the infection. The influence of specific therapy on the course of the psoriatic process is also not excluded. But interleukin status of patients with psoriasis is of the greatest interest. It is known that interleukin-6 (IL-6) plays an active role in pathogenesis of COVID-19 and cytokine storm arising at infection. It is also regarded as an indicator of inflammatory activity in psoriasis. In addition, IL-6 is involved in lipid and hepatobiliary disorders in this group of patients. It is also associated with IL-17, the role of which has been well studied in psoriasis and autoimmune hepatitis. Patients with psoriasis often have changes in biochemical blood parameters, similar to those seen with COVID-19. Combinations of all these factors can lead to exacerbation of psoriasis with predominance of erythroderma and toxic component. In our opinion, in such cases it is necessary to include in the therapy a systemic hepato-protective drug containing glycyrrhizic acid. It has a pronounced anti-inflammatory effect, inhibits IL-6 production and allows to achieve significant improvement of psoriatic process in a short time. © 2022, Remedium Group Ltd. All rights reserved.
ABSTRACT
A new SARS-CoV-2-associated coronavirus infection pandemic began in late 2019. The present article is devoted to the analysis of the mechanisms of COVID-19 impact on the course of psoriasis and its consequences. According to the scientific literature, patients with psoriasis are somewhat more likely to be infected with coronavirus infection than the healthy population, but tolerate it in a milder form. At the same time, cases of psoriatic process exacerbation during the active phase of the disease and after COVID-19 have been described. The negative effect of infection on skin disease can be explained by the common genome of the two nosologies, the «cytokine storm» and the prescription of COVID-19 drugs. In addition, both COVID-19 and psoriasis can cause liver dysfunction related to the specific pathogenesis of the diseases as well as the prescribed therapy. The article describes our own experience of monitoring patients with exacerbation of psoriasis against the background of coronavirus infection with pathological changes in liver tests. Inclusion of a fixed combination of glycyrrhizic acid and essential phospholipids in the complex treatment allowed to stop the exacerbation of the psoriatic process more effectively, to reduce the activity of liver enzymes without worsening the clinical conditions associated with COVID-19. Thus, in particular, a clinically significant improvement of the skin condition was recorded. In patient B., alanine aminotransferase activity decreased to 44.4 U/L and aspartate aminotransferase activity to 18.2 U/L. In turn, in patient M. the activity of liver enzymes decreased to 37.8 U/L and 34.7 U/L, respectively. The prescription of this drug can be considered pathogenetically justified, given the effect of glycyrrhizic acid on the production of key cytokines involved in the inflammatory process in psoriasis, coronavirus infection and liver pathology. In addition, the hypothesis of the ability of glycyrrhizic acid to prevent the entry of SARS-CoV-2 into the cell by reducing the expression of angiotensin-converting enzyme 2 is of interest. © Katkova K.V., Plieva K.T., Denisova E.V., Zhukova O.V., Volnukhin A.V., Korsunskaya I.M. 2021.