Online ISSN: 2515-8260

Keywords : psoriasis

Efficacy Of Methotrexate And Acitretin In Cases Of Psoriasis

Dr. Rajeev Kumar, Dr. Praveen Kumar Singh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 8-12

Background: Psoriasis is a systemic immune-mediated disease accompanied by arthritis in a significant percentage of patients called psoriatic arthritis. The present study was conducted to compare methotrexate and acitretin in cases of psoriasis.
Materials & Methods: 80 patients of palmoplantar psoriasis of both genderswere divided into 2 groups of 40 each. Group I patients were given oral acitretin 0.5mg/kg daily for 3 months and group II were given oral methotrexate15mg/week for 3 months. Modified psoriasis area severity index (MPASI)score was recorded. Improvement was graded as: no change, slight improvement, moderate, marked and almost cleared.
Results: There were 15 males and 25 females in group I and 20 males and 20 females in group II. The mean MASI score at baseline, 1 month, 2 months and 3 months was in group I was 61.2, 41.4, 31.2 and 21.6 and in group II was 58.4, 39.2, 24.5 and 15.4. The difference was significant (P< 0.05).
Conclusion: Both oral methotrexate and acitretin were highly effective in treating palmoplantar psoriasis. The reduction of Psoriasis lesions with Oral methotrexate was faster than acitretin.

A Review On Veppampattai Thylam For The Management Of Skin Diseases

V. Chitra, Manvizhi, N. Senthil Velu Kanthal, R. M. Pushparani, V. Mahalakshmi

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1277-1285

Siddha system of medicine is well known for its contributions towards skin diseases through its ancient texts. Veppampattai thylam is one among the external medication which has been   indicated for the treatment of chronic skin conditions like eczema, dermatitis, psoriasis, scabies etc. It is a herbal formulation containing Melia azadirachta bark (Veppampattai), Hemidesmus indicus root (Nannari ver), Rubia cordifolia root (Manjitti ver), Eletaria cardomom seeds (Elarisi). This herbal oil is being prescribed by Siddha physicians as it reduces the itching, burning sensations, skin lesions and inflammations that are common symptoms of the skin diseases. This paper deals with the scientific analysis on the pharmacological properties of these ingredients towards the treatment of chronic Skin diseases.


Dr.A.Brindha Pandian, Dr.C.Abhirami, Dr.G.Vinitha kumari, Dr.Many Naveen Kumar, Dr.SEVismitha

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 172-184

Psoriasis is a chronic inflammatory disease.There are various treatment modalities to control the disease, which are used alone or in combination. Narrowband ultraviolet B has gained pace in the treatment of moderate to severe Psoriasis. Phototherapy alone or combined with systemic therapy or systemic therapy alone is recommended as the first-line therapy in moderate to severe Psoriasis Vulgaris . Hence,the efficacy and safety of Narrow Band -UVB the rapyversus Narrow Band-UVB with topical Clobetasol propionate 0.05%is assessed in patients with psoriasis vulgaris.


Dr Kiran Vinayak, Dr J R Dash, Dr C R Srinivas,Dr Farzana N, Dr Hemanta Kumar Kar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1641-1649

Introduction: Psoriasis is a chronic inflammatory disease of skin and joint associated with cardiovascular morbidity.Previous studies have shown higher prevalence of metabolic syndrome in psoriasis patients.
Material & Methods: In this study 60 adult patients from each group with psoriasis and chronic eczemawere included for assessment of metabolic syndrome.Metabolic syndrome was diagnosed based on the presence of three or more criteria of the National Cholesterol Education Program, Adult Panel III (ATP III) with Asian modification for waist circumference.
Results: Metabolic syndrome was significantly more common in psoriatic patients than in eczema patients ((23)38.3% VS (13) 21.6%) P=0.046. Psoriatic patients had a higher prevalence of triglyceridemia, low HDL levels and elevated blood sugaras compared to those findings in chronic eczema group of patients.
Conclusion: In view of our study showing strong association between metabolic syndrome and psoriasis, it is recommended that all psoriasis patients should be screened for early detection of metabolic syndrome so as to prevent mortality and morbidity related to metabolic syndrome. In eczema, the prevalence of metabolic syndrome is comparable to that observed in normal population of this region.

Etiology of erythroderma: An observational study in a teaching hospital

Lakshmi Kamcharla, KV Sridevi, Mortha Lavanya, Nageswaramma Siddabattuni

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3453-3457

Introduction: Erythroderma is an intense exfoliative disease with generalized redness appearing all over the skin. Even when managed well, it is capable of causing many deaths. As a result a proper etiopathology of the disease has to be properly established to facilitate a timely and appropriate treatment.
Materials and methods: 203 patients who were clinically diagnosed for erythroderma were included in this study. Detailed demographic data, the time of onset, a history if any cutaneous diseases and the medications, comorbities, history of weight loss, history of pruritis, ungueal alterations, palmo-plantar keratoderma, ectropion was taken.
Results: 55.17% of the patients were males and 44.83% were females. The most common age group was 30- 50 years. The most common cause was psoriasis in nearly 50%, followed by drug reactions in 26.6% and idiopathic causes in 4.93%.
Conclusion: In our study, a large number of patients with erythroderma had psoriasis, proving that condition to be the most common cause, followed by drug reactions and idiopathic reasons.


D.SoundaryaMahanthi, P. V. Rajini, N. Jyothi, T. Arunmanas, T. Krishnasri Vathsav, T. Anvesh Buddha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1222-1232

Background:Psoriasis is the most prevalent chronic inflammatory disease, with an approximate worldwide prevalence of 2-3% [1]. The etiological factor is yet to be known but the genetic factor, trauma, skin infections, drugs, emotional stress like anxiety, alcohol, smoking etc greatly impact the clinical evolution of Psoriasis [2]. Oxidative stress which is induced by the excessive production of reactive oxygen species and inflammatory cytokines that play a significant role in the evolution of severe psoriatic plaques. Serum Paraoxonase is synthesized by the liver and is related with HDL particles.
Materials and Methods: Sample Collection– After 12 hours of fasting, a morning sample of 5 ml of venous blood has been collected from the antecubital vein from each subject under aseptic conditions. Parameters Serum Paraoxonase using paranitrophenol substrate by spectrophotometric method. Serum Lipidprofile Serum totalcholesterol by CHOD-PAP Enzymatic photometric method. Serumtriglycerides by GPO-POD method. Serum Hdl- cholesterol by Direct Enzymatic Cholesterol- DL estimation in the presence of detergent. Serum LDL-Cholesterol estimated by Friedewald formula. Serum VLDL- Cholesterol is estimated automatically by dividing triglyceride by5.
Results: The [mean ± SD] age of the cases was 43.67±11.069 and in the controls 42.8±11.679 years. Statistical analysis showed that there was no statistical difference in age between the two groups (as the P-value is > 0.005). The [mean±SD] basal PON activity in cases was 69.08±13.03 and in controls was 74.46±9.79. There is statistical significance in the basal PON activity between the two groups. The mean serum total cholesterol is increased incases (p value is 0.630) when compared with controls, but it is not statistically significant. there is a high significance in the serum high densitylipo protein (HDL-C) between the two groups: 1. The mean increase in the levels of serum low densitylipo protein (LDL-C) cases are statistically significant when compared with controls. There was a high statistical significance in the serum triglycerides levels between the two groups.
Conclusion: This study was undertaken to study the levels of serum Paraoxonaseandserum lipid profile in 40 patients who are diagnosed with psoriasis to assess the irrole in causing cardiovascular diseases. 2. Inpsoriasis, the elevated levels of triglycerides, low densitylipo protein and very low-density lipoprotein are due to lowered levels of hepatic lipase at acute phase reaction, results in elevation of triglycerides in serum. Decreased levels of HDL-C levels are observed because the systemic Inflammation caused by cytokines. As PON is associated with HDL. The PON levels are affected by the decrease in HDL levels and results in lipidperoxidation along with formation of Oxidised LDL. This OX-LDL accumulates in the smooth muscle of artery and causes atherosclerosis.


Vijaitha S M, MDSabiullah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11604-11610

Background:To assess the statistically significant difference in the serum lipid profile levels in the psoriasis cases and healthy controls and to evaluate atherogenicity in psoriatic patients which is a risk factor for cardiovascular disease.Psoriasis is a common and recurrent proliferative inflammatory skin disease that has been influenced by abnormal plasma lipid metabolism, genetic, environmental, viral, immunological factors and with high frequency of cardiovascular morbidity and mortality. Biochemically Psoriasis leads to increased synthesis and degradation of nucleoproteins, it is also associated with changes in blood biochemistry. This study was done to establish the correlation of lipid profile in the psoriasis patients and also to evaluate the risk of atherogenicity in psoriatic patients which is a risk factor for cardiovascular disease. Blood samples were analysed for the following parameters in lipid profile, total cholesterol, LDL, HDL, Triglycerides. A significant relation was found with dyslipidemia and increased risk of atherogenicity in psoriasis disease and severity of diseases in which the risk factors and secondary causes of hyperlipidemia were excluded.
Materials and Methods: Present study was done at Department of Biochemistry, Maheswara Medical College, Hyderabad and analysed fasting lipid profile in 160 patients diagnosed with mild to severe psoriasis and 160 age and gender matched healthy subjects as the control group in the period of 20 months.
Results: Subjects presented considerable risky elevation in lipid profile, serum total cholesterol (p<0.001), triglyceride (p 0.002), LDL-cholesterol (p<0.001), VLDL-cholesterol (p<0.001) and free fatty acids (<0.001) were found to be significantly higher than in control group. Significant decrease in statistical analysis was observed in HDL (p<0.001) levels of the two groups. Significant positive correlation in total cholesterol, LDL, VLDL and FFA was found between mild, moderate and severe psoriasis (PASI score) as compared with controls.
Conclusion: Present data suggest that psoriasis patients must be considered as a group at high risk for cardiovascular, since psoriasis per se seems to be associated with risk changes in the lipid profile. We conclude that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and cardiovascular diseases.

A case-control study of Apolipoprotein E Gene amongpsoriasis patients

Farhat Fatma, Dr. Jaya Jain, Dr. Ashutosh Jain, Dr. Anshuman Rai, Dr. M S Chandel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 126-133

Introduction: Psoriasis is a chronic skin disease of unclear aetiology and pathogenesis
which is characterized by an inflammatory infiltration in dermis and epidermis,
proliferation of epidermal cells – keratinocytes which clinically manifests with the
formation of erythemato-squamose papules, and is often accompanied by the
engagement of joints and nails in the process of inflammation.
Materials and Methods: This is a case-control study conducted at Department of
Biochemistry, Central Research Lab and Central Clinical Lab of GMC Azamgarh. The
subjects will be selected as per the inclusion/ exclusion criteria. A detailed clinical
history including age, sex, and occupation will be collected from the patients after
obtaining written and informed consent. For ApoE: Genomic Dna is extracted from
blood using QIAamp DNA minikit. The genotypes of the APOE polymorphisms is
determine by using APOE strip assay kit based on polymerase chain reaction and
reverse-hybridization technique.
Result: A total of 380 patients who fulfilled the selection criteria during the study were
enrolled, they were divided into two groups case and control each group consist of 190
patients. Maximum number of (41.5%) patients are seen during <1 years of duration of
psoriasis followed by 1-2 years are 27.8%, 2-3 years are 22.1% and least are 4-5 years
are 1.5%. Most of the patients has plaque type of psoriasis are 88.4% followed by
Guttate 8.9% and few are Pustular and Exfoliative 1.5% and 1.0% respectively.
Severity of psoriasis is mild 17.8%, moderate 48.4% and severe 33.6%. Apolipoprotein
E alleles in cases are𝜀3 83.1% followed by 𝜀4 12.1% and 𝜀2 4.7%. On the other hand, in
control group 𝜀3 94.2% and 𝜀4 10%.
Conclusion: Apolipoprotein E may be used as a marker to predict those patients with
psoriasis who are at risk of dyslipidemia and probably CVD. Based on the results of our
study, we recommend regular monitoring of patients with psoriasis for the presence of
comorbidities which have a definite adverse effect on both psoriasis and the CVS.

Assessment of serum ADA and hsCRP level in psoriatic patients

Dr.Deepika Agarwal, Dr.Bhawna Kapoor

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1830-1834

Background:Psoriasis is a chronic, immune-mediated skin disease. The present study was
conducted to assess serum ADA and hsCRP level in psoriatic patients.
Materials & Methods:66 patients of Psoriasis of both genders were divided according to
PASI score <10 defined psoriasis asmild, between 10 and 20 as moderate, and >20 assevere.
Each group contains 22 patients. 25 healthy subjects were included as a control group. Serum
ADA and hsCRP levelwere measured in psoriatic patients.
Results: Control group had 10 males and 15 females, mild had 13 males and 9 females,
moderate had 12 males and 10 females and severe had 11 males and 11 females. ADA level
was 8.2 U/L in control group and 23.1 U/L in psoriasis patients. The mean hsCRP level in
control group was 9.0 ng/ml and 54.2 ng/ml in psoriasis group. The difference was significant
(P< 0.05).
Conclusion: Serum ADA and hsCRP had higher levels among psoriatic patients than healthy

A hospital based assessment of the effects of various topical agents in chronic plaque type psoriasis

Dr. Shribhagawan Rolaniya, Dr. Apeksha Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1005-1008

Aim: To determine the effect of various topical agents in chronic plaque type psoriasis.
Materials and Methods: The study was carried out on patients having chronic plaque type psoriasis vulgaris came to Department of Skin & VD, Medini Rai Medical College, Palamu, Jharkhand, India. Total 300 patients were enrolled and were divided into three groups comprising of 100 patients in each group. Group A patients were asked to apply ammonium lactate twice a day, Group B patients were asked to apply ammonium lactate in morning and clobetasol propionate in evening, Group C patients were asked to apply topical ammonium lactate in morning and calcipotriol in evening.
Results: Physician global assessment scale shows that in Group A, 39% patients had excellent response, 15% patients had good response, and 21% patients had fair response whereas 25% patients had poor response. In group B, 35% patients had excellent response, 29% patients had good response, and 17% patients had fair response whereas 19% patients had poor response. In group C, 31% patients had excellent response, 28% patients had good response, and 22% patients had fair response whereas 19% patients had poor response.
Conclusion: Combination therapy is effective, well tolerated with minimal side effects and better compliance was seen with patients. Ammonium lactate 12% can also be considered as one of the topical option as a monotherapy and also as a maintenance therapy.

Nimesulide induced flaring in psoriasis

Dr Harmeet Singh, Dr Dheeraj Nair, Dr Nishant Sahu, Dr Syed Tauseeful Haque

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3840-3842

Background: Nimesulide is a cyclooxygenase (COX) inhibitor with a high degree of selectivity to COX-2. It is a widely used and well tolerated non steroid anti-inflammatory drug that also has analgesic and antipyretic properties. The most frequently reported side effects concern the GI tract. Pruritus and skin rash are the most common cutaneous adverse reactions. Case report: This is a case report of a 58 years old patient who came to ER with develop wheal, multiple joint pain sparing PIP/DIP joint, fever, generalized weakness, decrease oral intake afternimesulide ingestion.He also gave a history of psoriatic arthritis.He was managed with intravenous steroids, antibiotics, antihistaminic & iv analgesics Result:After 2days of medications his general condition improved, joint pain reduced, appetite improved and discharged on oral medicationsConclusion: Drug induced flare is common cutaneous drug reaction, often misdiagnosed. A detailed history taking and physical examination are the key to suspect this condition.

Study of skin expression of thrombomodulin in the Psoriatic Plaques

May mostafa Abo Al-kher MSc; Sawsan Khalifa Elsayed M.D; Safinaz Salah Eldin Sayed M.D; Sara Ahmed Galal M.D

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1625-1637

Background: Psoriasis is a chronic relapsing, immune-mediated inflammatoryskin disease of unknown etiology. The role of thrombomodulin (TM) in different autoimmune inflammatory diseases was explored previously in some studies. Thus; the aim of this study was to assess TM expression in the affected skin of patients with psoriasis.
Methods: This prospective case-control study was carried out on 30 patients with chronic plaque psoriasis and 30 age and gender matched apparently normal subjects as a control group. Skin biopsies were taken for immunohistochemical evaluation of TM expression.
Results: There was a highly significant difference between the two studied groups regarding the expression of TM in the skin. Patients group had a higher expression of TM in both epidermis and dermis compared to controls with a highly statistically significant difference, P-value< 0.01.


Abdulrhman M. Hassan Hadi; Ahmed Abdul-Hassan Abbas; Ahmed Sahib Abdulamir; Basman Medhat Fadheel

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 240-246

Background: Psoriasis is a chronic inflammatory skin disease has a strong genetic predisposition. Aim of the work: To study the role of TNFAIP3 rs610604 (C/A) polymorphism in psoriasis, and its effect on Etanercept response. Subjects and methods: One hundred patients with psoriasis, in addition 100 apparently healthy individuals as a control group were included in this study. Restriction Fragment Length Polymorphism-Polymerase Chain Reaction (RFLP-PCR) was performed to evaluate different TNFAIP3 gene polymorphism. TNFAIP3 serum levels were assessed by enzyme-linked immunosorbent assay. Results: Current study showed low serum level of TNFAIP3 protein in psoriatic patients when compared with control group (P<0.01). A considerably higher risk of psoriasis was observed in individuals who had TNFAIP3 rs610604 SNP CC and C allele than people carrying AA genotype and A allele. In relation to the response to treatment, this study observed that the mutant homozygous genotype CC was more frequent in non -responder (71.4%) than responder (1.3%) patients (P<0.01). Conclusion: TNFAIP3 rs610604 (C/A), might be useful for prognosis of psoriatic patients


Dr. Sneha Deshmukh; Dr. Adarshlata Singh

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2158-2165

Background/Rationale: Skin is the most visible organ that defines our appearance and plays a significant social communication role to a great extent. Human beings are often concerned with their external physical appearance, which is directly related to the health of the skin, and if any disease triggers a change in the skin's natural appearance, it causes distress to the individual. Chronic diseases such as Vitiligo, Psoriasis, and Pemphigus severely dagrades the quality of life ( QOL) of affected individuals. ,Psychiatric morbidity was shown by Indian patients as stress ,anxiety depression, lower self-esteem, adjustment disorders, and sleep disturbance, and are vulnerable to various psychiatric disorders such as severe depression and suicidal ideations. The involvement of a chronic illness is typically associated with lower health-related quality of life ( HRQOL), and severity of the disorder often affects HRQOL. Objectives: To evaluate the quality of life of patients having Psoriasis, Vitiligo and Pemphigus Vulgaris and To explore the correlation between disease severity and quality of life. Methods: Prospective Cross sectional Study will be carried out in 65 patients with chronic skin diseases, attending Out Patient Department of Dermatology, AVBRH, JNMC, Sawangi, Wardha, will be Registered after having considered different conditions for inclusion and exclusion. A detailed history will be taken, severity index will be calculated and questionnaire, DLQI, HRQOL will be given to the patients. Results: The result would be undertaken in SPSS software. Conclusion: The conclusion will be based on findings for study protocol.

Cyperous Rotundus Active Compounds for Psoriasis Therapy with in Silico Analysis

Mardiana .; Muh Eko Irawanto; Ferry Arrochman; Primadhanty Bhadra; Adniana Nareswari; Halim PK; Nugrohoadji dharmawan; Endra Yustin; Prasetyadi M; Didik H. Utomo; Anggia N. Ramadhani; Ria Margiana

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 1266-1272

The choice of therapy in mild to moderate level of psoriasis includes topical therapy. In silico is an analog computerized experiment which is similar to in vivo and in vitro biological experiment. Cyperus rotundus or nut grass has antipsoriatic activity so that it can be used as a topical herbal medicine in reducing psoriasis severity. The aim of this study was intended to evaluate the content of Cyperus rotundus using in silico analysis in psoriasis treatment. Active compound of extracted Cyperus rotundus is taken from the knapsack database. Simplified Molecular Input Line Entry System (SMILE) format is taken from the pubchem database. The predictions on skin barrier repair, immunosuppressors, anti-inflammatory and antipruritic agents are performed by using a pass server. The molecular mechanism of active compounds in the human body is taken from the search tool for interacting chemicals (STITCH) which is experimentally predicted; then it is computationally analyzed. Further pathway analysis uses cytoscape software. There are 21 active compounds on Cyperus rotundus. The potential of Cyperus rotundus as immunosuppressor, anti-inflammatory, and antipruritic is predicted to have activity that is examined computationally, but this has not been proven in laboratory experiment or has small potential. The highest potential of Cyperus rotundus bioactivity in improving skin barrier which has the most function is beta-selinene with an average value of probable to be active (Pa) 0.715 predicted to have high potential computationally and laboratory tests. Overall, Cyperus rotundus is a good option for psoriasis therapy in improving skin barrier function, immunosuppressors, anti-inflammatory and antipruritic because it has beneficial effectiveness in terms of the availability and safety.