Circulating hyaluronate in psoriasis.

A radioassay method allowing measurements of low concentrations of circulating hyaluronate was used in a study of serum hyaluronate concentrations in 44 patients with psoriasis. Twenty-three of them had only skin lesions and 21 had both skin lesions and arthropathy. In both of these groups significantly elevated serum levels of hyaluronate were found. The highest values were observed in those with widespread and active skin disease and/or active arthritis. Serum hyaluronate positively correlated with the plasma concentrations of alpha 1-antitrypsin and haptoglobin and also with ESR, which may indicate a relationship between acute inflammation and increased production of hyaluronate. Seven patients with widespread atopic dermatitis included for comparison had normal hyaluronate values. In blister fluid from lesional skin in two patients with acute psoriasis, very high concentrations of hyaluronate were found, in comparison with the concentrations in blister fluid from non-involved skin. The increased concentration of serum hyaluronate in psoriasis indicates involvement of dermal and synovial tissue in psoriasis, in addition to the epidermal changes.