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Subject Area

Radiology and Imaging Sciences

Article Type

Original Study

Abstract

Purpose To estimate serum elafin concentration in patients with psoriasis for psoriasis diagnosis and to correlate its levels with psoriasis severity and other inflammatory markers, that is, high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate (ESR). Background Psoriasis is a chronic, immune-mediated, multisystem disease with keratinocyte hyperproliferation. Elafin is a serine elastase inhibitor, produced by epithelia, that is upregulated by inflammatory stimuli. Serum elafin concentration increases significantly in the presence of inflammation. Patients and methods This prospective case–control study was carried out on 20 patients with psoriasis and 20 age-matched and sex-matched healthy controls. All enrolled participants were subjected to a full history taking, general and detailed dermatological examination, and laboratory investigation of ESR, serum elafin, and hs-CRP concentrations. Results Serum elafin concentration was statistically significant (P = 0.001) higher in the patient group (2.54 ± 1.54) when compared with the controls (0.85 ± 0.39). There was a statistically significant (P = 0.001) difference among subgroup patients according to disease severity regarding serum elafin concentration. There was a highly significant positive correlation between serum elafin concentration and disease severity, ESR, and serum hs-CRP among studied patients with psoriasis (r = 0.876, P = 0.000; r = 0.689, P = 0.000; and r = 0.726, P = 0.000, respectively). The serum elafin concentration could be used to diagnose psoriasis with cutoff points higher than 1.35 ng/ml (with 88.24% sensitivity and 78.26% specificity) and also can detect its severity with cutoff points higher than 1.75 ng/ml, with 93.33% sensitivity and 100% specificity, to differentiate the mild cases from moderate and severe ones. Conclusion The serum elafin concentration represents a useful tool for diagnosis of the inflammatory nature and monitoring the disease activity in patients with psoriasis.

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