Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, R Campo Alegre 823, 4150 Porto, Portugal.
Am J Clin Dermatol. 2013 Feb;14(1):49-53. doi: 10.1007/s40257-012-0002-8.
Periods of remission and of exacerbation of psoriatic lesions are common in psoriasis. We recently reported C-reactive protein (CRP) as a marker of psoriasis severity and that some patients still presented with a residual inflammation after treatment. We wondered if this residual inflammation could underlie an earlier exacerbation of psoriasis.
The purpose of our study was to evaluate if there is a relationship between CRP levels, Psoriasis Area and Severity Index (PASI), and body mass index (BMI), at the end of psoriasis treatment, with the length of psoriasis remission.
We followed 46 patients studied at the end of treatment, to record the length of remission; 9 of the patients were treated with topical agents, 17 with narrow-band UVB (NB-UVB), and 20 with psoralen plus UVA (PUVA).
We found that the length of remission correlated with the values for PASI and CRP at the end of therapy. By performing a multiple linear regression analysis, CRP, PASI, and BMI were each significantly associated with length of remission. Patients with residual inflammation at the end of treatment presented with a significantly shorter length of remission. When considering patients grouped according to the used therapies, CRP and PASI also emerged as potential determinants of length of remission, especially in the case of patients treated with NB-UVB and topical therapy.
Our data suggest that CRP and PASI are important determinants of length of psoriasis remission for patients treated with phototherapy or topical therapy. Further studies with larger groups of patients are warranted to test this hypothesis. Moreover, we propose that, by the end of the treatment, the evaluation of CRP and PASI could be important to decide, when possible, if the treatment should be continued to achieve lower CRP values and longer periods of remission.
银屑病皮损的缓解期和加重期很常见。我们最近报道了 C 反应蛋白（CRP）是银屑病严重程度的标志物，并且一些患者在治疗后仍存在残留炎症。我们想知道这种残留炎症是否会导致银屑病更早加重。
本研究旨在评估银屑病治疗结束时 CRP 水平、银屑病面积和严重程度指数（PASI）和体重指数（BMI）与银屑病缓解期长度之间是否存在关系。
我们随访了 46 名在治疗结束时接受治疗的患者，以记录缓解期的长度；其中 9 名患者接受局部治疗，17 名患者接受窄带 UVB（NB-UVB）治疗，20 名患者接受补骨脂素加 UVA（PUVA）治疗。
我们发现缓解期的长度与治疗结束时的 PASI 和 CRP 值相关。通过进行多元线性回归分析，CRP、PASI 和 BMI 均与缓解期长度显著相关。治疗结束时存在残留炎症的患者缓解期明显缩短。当考虑根据所使用的治疗方法对患者进行分组时，CRP 和 PASI 也成为缓解期长度的潜在决定因素，尤其是在接受 NB-UVB 和局部治疗的患者中。
我们的数据表明，CRP 和 PASI 是接受光疗或局部治疗的患者银屑病缓解期长度的重要决定因素。需要进一步进行更大样本量的研究来验证这一假设。此外，我们建议在治疗结束时，评估 CRP 和 PASI 对于确定是否应继续治疗以达到更低的 CRP 值和更长的缓解期非常重要。
