Comparison of Mean Serum Prolactin Levels between Healthy and Psoriatic Patients

Abstract

ABSTRACT Background: Psoriasis is a chronic inflammatory dermatosis marked by hyper-proliferation and defective differentiation of epidermal keratinocytes, as well as increased angiogenesis in the dermis and hyper-activation of inflammatory cells such as T cells and dendritic cells. The etiopathogenesis of these changes is yet to be determined. However, recent studies have reported significantly higher mean serum prolactin level in psoriatic patients and have claimed raised serum prolactin level as endocrinological basis of pathological changes observed in psoriasis. However, there was controversy in the existing literature on comparison of mean serum prolactin level of healthy and psoriatic patients. The present investigation was necessary because there was no local published research on psoriatic patients. OBJECTIVES: The goals of this study were to evaluate the mean blood prolactin levels between healthy and psoriatic patients and to ascertain the prevalence of psoriasis in patients presenting to a teaching hospital in Punjab. Methodology: This study involved 153 patients of both genders aged between 18-70 years who presented at outpatient department of Dermatology, Mayo Hospital Lahore. 153 patients of both genders aged between 18-70 years were evaluated for psoriasis which was diagnosed clinically by the presence of red inflamed, sharply demarcated, indurated plaques, with silvery white scales over extensor surfaces and scalp for ≥6 months. 5ml of venous blood was sampled through venipuncture and was sent for serum prolactin level estimation. Mean serum prolactin level was compared between patients with and without psoriasis. A written informed consent was taken from each patient. RESULTS: The patients were 40.11±4.9 years old on average. The majority of the patients (n=103, 67.3%) were in the 18–44 age range. Male to female ratio was 2:1, with 102 (66.7%) men and 51 (33.3%) women among the patients. These individuals serum prolactin levels ranged from 5.6ng/ml to 15.9ng/ml, with an average of 8.9±2.3ng/ml. Six individuals (3.9%) had psoriasis, which was identified. The prevalence of psoriasis did not differ statistically significantly by gender (p-value=1.000) or by age (p-value=0.972). Patients with psoriasis had considerably higher mean serum prolactin levels than those without psoriasis (14.80±1.05 vs. 8.68±1.97 ng/ml; p-value 0.001). Patients with and without psoriasis were divided into several subgroups based on patient's age, with similar substantial differences in mean serum prolactin level being identified. CONCLUSION: In the present study, 3.9% of patients presenting in dermatology outpatient department had psoriasis and these patients had significantly higher mean serum prolactin level compared to those without psoriasis which might be a potential therapeutic target and necessitates further studies in this regard to establish cause-effect relationship. KEY WORDS: Psoriasis, Keratinization, Serum Prolactin