The role of hematological markers in prediction of severity of psoriasis and associated arthritis
Keywords:
Psoriasis, NLR, PLR, Psoriatic arthritisAbstract
Background: Nowadays, role of hematologic markers including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as cost-effective and reliable tests, in recognition of chronic inflammatory and autoimmune diseases, as well as prediction of their prognosis has been elucidated. In this study we investigate role of these factors in prediction of severity of psoriasis and associated arthritis. Material and method: This is a retrospective cross-sectional study on thirty moderate-to-severe psoriasis patients, hospitalized in dermatology ward, and thirty aged- and sexed-matched healthy adults. NLR/PLR in psoriasis patients was compared to healthy controls. Furthermore, NLR/PLR of classic type of psoriasis was compared to other types of psoriasis (including psoriatic arthritis and erythrodermic psoriasis) by variance analysis. Correlation of demographic features with NLR/PLR was assessed via chi-square test and independent t test. Results: Mean age of patients in psoriasis and control groups was 35.66 ± 16.62 and 39.8 ± 11.18, respectively. Psoriasis patients had significantly higher NLR/PLR compared to control groups (3.47 ± 3.83 vs. 1.37 ± 0.55 and 133.26 ± 83.99 vs. 96.25 ± 40.72, respectively). The highest and lowest NRL/PLR belonged to erythrodermic and vulgaris types, respectively. Moreover, there was no significant correlation between NLR/PLR and psoriasis patients, with or without underlying disease. Conclusion: NLR/PLR can be a useful indicator for psoriasis severity and associated arthritis. It might be helpful in selection of type of treatment in psoriasis patients and employed as a prognostic factor in prediction of disease course and possible accompanied morbidities.References
Armstrong AW, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA. 2020 May 19;323(19):1945-60.
Brandon A, Mufti A, Sibbald RG. Diagnosis and management of cutaneous psoriasis: a review. Adv Skin Wound Care. 2019 Feb 1;32(2):58-69.
Harden JL, Krueger JG, Bowcock AM. The immunogenetics of psoriasis: a comprehensive review. J Autoimmun. 2015 Nov 1; 64:66-73.
Naldi L. Scoring and monitoring the severity of psoriasis. What is the preferred method? What is the ideal method? Is PASI passé? Facts and controversies. Clin Dermatol. 2010 Jan 1;28(1):67-72.
Gökalp H. Effect of psoriasis severity on inflammation parameters: Controlled study. Turk J Dermatol. 2018 Jan 1;52.
Paliogiannis P, Satta R, Deligia G, et al. Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis: a systematic review and meta-analysis. Clinical and experimental medicine. 2019 Feb;19(1):37-45.
Ustuner P, Balevi A, Olmuscelik O, et al. Is there any correlation between red cell distribution width, mean platelet volume neutrophil count, lymphocyte count, and psoriasis area severity index in patients under treatment for psoriasis? Acta Dermatovenerol Croat. 2018 Oct 22;26(3):199-.
Gruchała A, Cisłak A, Golański J. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as an alternative to C-reactive protein in diagnostics of inflammatory state in patients with psoriasis. Our Dermatology Online/Nasza Dermatologia Online. 2019 Jan 1;10(1).
Aktaş Karabay E, Demir D, et al. Evaluation of monocyte to high-density lipoprotein ratio, lymphocytes, monocytes, and platelets in psoriasis. Anais Brasileiros de Dermatologia. 2020 Mar 30;95:40-5.
Yurtdaş M, Yaylali YT, Kaya Y, et al. Neutrophil‐to‐lymphocyte ratio may predict subclinical atherosclerosis in patients with psoriasis. Echocardiography. 2014 Oct;31(9):1095-104.
Toprak AE, Ozlu E, Ustunbas TK, et al. Neutrophil/lymphocyte ratio, serum endocan, and nesfatin-1 levels in patients with psoriasis vulgaris undergoing phototherapy treatment. Med Sci Monit. 2016; 22:1232.
Ataseven A, Bilgin AU, Kurtipek GS. The importance of neutrophil lymphocyte ratio in patients with psoriasis. Mater Sociomed. 2014 Aug 26;26(4):231-3.
An I, Ucmak D, Öztürk M, et al. Neutrophil/Iymphocyte ratio, platelet/Iymphocyte ratio, mean platelet volume and C-reactive protein values in psoriatic arthritis patients. Ann Med Res 2019;1-5.
Wang WM, Wu C, Gao YM, et al. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and other hematological parameters in psoriasis patients. BMC Immunol. 2021 Dec;22(1):1.
Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016 Mar;43(3):305-10.
Arısoy A, Karaman K, Karayakalı M, et al. Evaluation of ventricular repolarization features with novel electrocardiographic parameters (Tp-e, Tp-e/QT) in patients with psoriasis. Anatol J Cardiol. 2017 Jun;18(6):397.
Çerman AA, Karabay EA, Altunay İK. Evaluation of neutrophil-lymphocyte ratio and mean platelet volume in patients with psoriasis. Sisli Etfal Hastan Tıp Bul. 2016;50(2):137-41.
Pektaş SD, Alataş ET, Yılmaz N. Plateletcrit is potential biomarker for presence and severity of psoriasis vulgaris. Acta Med Mediterr. 2016, 32: 1785.
Yildiz A, Ucmak D, Oylumlu M, et al. Assessment of atrial electromechanical delay and P‐wave dispersion in patients with psoriasis. Echocardiography. 2014 Oct;31(9):1071-6.
Dey AK, Teague HL, Adamstein NH, et al. Association of neutrophil-to-lymphocyte ratio with non-calcified coronary artery burden in psoriasis: Findings from an observational cohort study. J Cardiovasc Comput Tomogr. 2021 Jul 1;15(4):372-9.
Sen BB, Rifaioglu EN, Ekiz O, et al. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol. 2014 Sep 1;33(3):223-7.
Najar Nobari N, Shahidi Dadras M, Nasiri S, et al. Neutrophil/platelet to lymphocyte ratio in monitoring of response to TNF‐α inhibitors in psoriatic patients. Dermatol Ther. 2020 Jul;33(4):e13457.
Asahina A, Kubo N, Umezawa Y, et al. Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017 Oct;44(10):1112-21.
Polat M, Bugdayci G, Kaya H, et al. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2017 Oct 1;26(4):97-101.
Solak B, Dikicier BS, Erdem T. Impact of elevated serum uric acid levels on systemic inflammation in patients with psoriasis. Angiology. 2017 Mar;68(3):266-70.
