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Abstract Psoriasis is a chronic, recurrent, immune-mediated inflammatory disease and is characterized by epidermal hyperplasia, dilated and prominent blood vessels in the dermis, and an inflammatory infiltrate of leukocytes, predominantly in the dermis. It affects 1-3% of the world population and characterized by well-demarcated erythematous plaques with adherent silvery scales. The most frequent areas of involvement include the elbows, knees, lower back, and buttocks but the disease can involve any cutaneous surface. Variations in the morphology of psoriasis have been classified into several clinical subtypes as plaque psoriasis, guttate psoriasis, erythrodermic psoriasis, psoriatic arthritis and pustular psoriasis. The pathogenesis is not known but it is mostly the outcome of interplay between different factors including genetic, metabolic and environmental triggers. In humans, uric acid is the final breakdown product of purine metabolism. The two purines (Adenine and guanine) are sequentially degraded by a series of enzymes to form xanthine and hypoxanthine. Both compounds are then oxidized by a final enzyme, called xanthine oxidase to produce uric acid. Uric acid is a heterocyclic organic compound with the formula C5H4N4O3 (7.9- dihydro-1 H-purine-2, 6.8 (3H)-trione) and a molecular weight of 168 Daltons. Increased serum uric acid is accepted as a common finding in patients with psoriasis. Enhanced purine catabolism due to the increased epidermal cell turnover is thought to be the cause of the raised serum uric acid. Therefore, a correlation of the serum uric acid concentration (SUAC) with the extent of skin involvement would be expected. Hyperuricemia is an abnormally high level of uric acid in the blood. In the pH conditions of body fluids, uric acid exists largely as urate, the ion form. The amount of urate in the body depends on the balance between the amount of purines eaten in food, the amount of urate synthesised within the body (e.g., through cell turnover), and the amount of urate that is excreted in urine or through the gastrointestinal tract. The aim of the work is to assess any association between serum uric acid and clinical features of psoriasis. This study was conducted at the Dermatology and Medical Biochemistry Department, Faculty of Medicine, Menoufia University. The study included 100 patients with chronic generalized psoriasis. These patients were collected from Outpatient Clinic of Dermatology, Andrology and STDs Department, Menoufia university hospital. In addition to 100 age and gender matched healthy individuals served as control group. Subjects of this study were categorized as two groups: Group1: included 100 psoriatic patients. The diagnosis of psoriasis was based on PASI score calculation [253]. According to PASI score they were subdivided into 3 subgroups: group 1a: Included 54 patients with mild psoriasis (PASI<5). They are 28 males and 26 females with mean age ± SD 37.3±13.25 years. Summary 52 group 1b: Included 39 patients with moderate psoriasis (PASI 5-15). They are 26 males and 13 females with mean age ± SD 40.7±16.65 years. group 1c: Included 7 patients with severe psoriasis (PASI>15). They are 7 males with mean age ± SD 37.7±14.95 years. Group2: Included 100 ages and gender matched healthy subjects served as controls. All studied subjects subjected to complete history taking, clinical, dermatological examination including assessment of PASI score, calculation of BMI. Blood samples were taken for detection of serum uric acid level. The results of the present study can be summarized as follow: There is non-significant statistical difference between patient’s subgroups regarding age and BMI. Whereas significance difference in gender existed. The number of lesions in the majority of patients in group 1a and 1b is two sites. In group 1c the majority of patients are affected in three sites. The duration of disease was less than 10 years in 81.5% in group 1a, 76.9% of group 1b and 85.7 of group 1c. The disease is stable in 96.3% of group 1a patients, 46.2% of group 1b patients. Whereas all patients of group 1c are unstable. There is significant statistical increase of PASI score in group 1c compared to group 1a and group1b. Also a significant increase existed in group 1b compared to group 1a. There is significant statistical increase in serum uric acid in patients compared to controls. There is significant statistical increase in serum uric acid in group 1c compared to group 1b and group 1a. There is non-significant statistical increase in the serum uric acid level in male than female patients. There is non-significant statistical increase in serum uric acid level in patients with duration of disease more than 10 years than those less than 10 years. There is significant positive correlation between serum uric acid level and each of age, duration of disease and PASI score in group 1. There is significant statistical difference between hyperuricemic (uric acid >7 in men &6 in women) and normouricemic psoriatic patients regarding site of lesion and stability. Whereas nonsignificant statistical difference existed regarding duration of disease and PASI score. |