الفهرس 
PsoriasisOnly 14 pages are availabe for public view
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Abstract
Psoriasis is an autoimmune, chronic, inflammatory skin disorder and characterized by epidermal hyperplasia, dilated and prominent blood vessels in the dermis and inflammatory infiltrate of leucocyte, predominantly in the dermis.
It affects 2-4% of general population, its prevalence in Egypt ranges from 0.6 to 4.8%.Characterized by well demarcated erythematous plaques with adherent silvery scales.
The most frequent areas affected are elbows, knees ,lower back and buttocks but any other cutaneous surface can be affected .Variation in the morphology of psoriasis had been classified into several subtypes as plaque type, guttate type, erythrodermic type ,psoriatic arthritis and pustular psoriasis.
The exact cause of psoriasis is unknown, but it may be the net result of the interaction among genetic, environmental and immunological factors.
Psoriasis is associated with cardiovascular risk factors, as hypertension, diabetes mellitus, dyslipidemia, obesity, and the metabolic syndrome .Patients with psoriasis have a high risk of developing severe vascular events such as cardiovascular and cerebrovascular diseases.
The pathogenic link between psoriasis and cardiovascular comorbidity is likely provided through insulin resistance and endothelial dysfunction, as these are known drivers for atherosclerosis.
BNP is a 32-amino acid-ringed peptide secreted by the ventricles, it is first synthesized as pre pro-BNP, which is then cleaved to pro-BNP and finally to BNP which is continuously released from the heart in response to both ventricle volume expansion and pressure overload.
NT-pro BNP plays an important role in the regulation of cardiac function. NT-pro BNP has vasodilator and diuretic effects, leading to decreased circulating blood volume, arterial pressure, central venous pressure, and cardiac output.
The aim of this study was to asses serum level of NBN in patients with psoriasis and to investigate the relationship between NBN level and echo cardio graphic changes in these patients.
This prospective study was carried out on 45 patients presented with Psoriasis. They were selected from dermatology outpatient clinic, Menoufia University Hospital during the period from October 2018 to march 2019. 39 age and gender matched apparently healthy volunteers were also included in this study as a control group. All studied cases were subjected to complete history taking, general and dermatological examination including grading of Psoriasis by PASI scoring and calculation of BMI. Blood samples were taken and sent to Biochemistry department, faculty of medicine, Menoufia University. Detection of NBN was done by ELISA.
In the present study, serum NBN was significantly elevated in cases compared to controls. Its elevation in cases could be due to associated insulin resistance, endothelial dysfunction and subsequent atherosclerosis.
In the current study, significant difference between cases and control regarding ECHO results .This may give evidence of cardio vascular risk in psoriatic patients.
In the current study, significant positive correlation between serum NBN and PASI score was detected. This may give evidence that the severity of psoriasis may reflect the severity of cardiac affection.
In addition, we found that high NBN level was associated with longer disease duration and in correlation analysis, there were a significant direct correlation between NBN levels and disease duration.
In the current study, high NBN level was associated with abnormal ECHO findings including pulmonary hypertension, ischemic heart disease and valvular heart disease. So NBN could be a useful diagnostic, prognostic and preventive biomarker for cardiovascular diseases in psoriatic patients.
Thus taken together, serum NBN elevation in psoriasis cases could be due to insulin resistance and endothelial dysfunction .This rise indicates early atherosclerosis, cardiovascular and echo changes in affected individuals. The severity of psoriasis is correlated with the level of NBN rise and ECHO finding. Prospective studies should be conducted in which these patients are closely followed-up in the long term, particularly for CVD.