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Rajasekharan, Abhiraj; Munisamy, Malathi; Menon, Vikas; Mohan Raj, P.S.; Priyadarshini, G.; Rajappa, Medha
Journal of psychosomatic research, July 2023, 2023-Jul, 2023-07-00, 20230701, Letnik: 170Journal Article
Psoriasis is an immune-mediated, chronic inflammatory disease affecting mainly the skin. Chronic stress leads to the blunted hypothalamic-pituitary-adrenal axis (HPA) that might induce pro-inflammatory conditions. Hence, we assessed the blood levels of the HPA hormones and interleukin-17 (IL-17) and the effect of stress and emotional distress to understand the link between stress and psoriasis better. This cross-sectional study included 45 patients with psoriasis and 45 age and gender-matched apparently healthy volunteers (n = 45). IL-17, cortisol, and adrenocorticotrophic hormone (ACTH) levels were assessed in both groups. Psoriasis Area Severity Index (PASI) was used to assess disease severity. Presumptive Stressful Life Events scale PSLE, Perceived Stress scale PSS and Daily Hassles and Uplifts Scale DHUS scoring were used to assess stress levels and emotional distress. Patients with psoriasis had higher levels of IL-17 and ACTH and lower levels of cortisol, as compared to controls. Stress scores (PSS, PSLE & DHUS) were significantly elevated in cases, as compared to the controls. IL-17, ACTH and stress scores showed a significant positive correlation with one another and a significant negative correlation with cortisol levels. They also showed a significant positive correlation with PASI, while cortisol levels showed a significant negative correlation. Psoriasis patients having high ACTH, IL-17 and stress scores had lower levels of cortisol, indicating a dysregulated HPA axis with the pro-inflammatory state. This might lead to exacerbation of psoriatic flares, which needs investigation in further prospective studies. •Psoriasis is a chronic inflammatory disease affecting the skin.•We undertook to elucidate the cross-section association between stress and psoriasis.•Those who experienced more stress displayed an unbalanced HPA axis and a pro-inflammatory condition.•Further research is warranted to evaluate if this could cause an increase in psoriatic flare-ups.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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