The Relationship of Hematological Parameters and C-reactive Protein (CRP) With Disease Presence, Severity, and Response to Systemic Therapy in Patients With Psoriasis

Gülsen Şener; Esma İnan Yuksel; Osman Gökdeniz; Kübra Karaman; Harbiye Dilek Canat

doi:10.7759/cureus.43790

The Relationship of Hematological Parameters and C-reactive Protein (CRP) With Disease Presence, Severity, and Response to Systemic Therapy in Patients With Psoriasis

Cureus. 2023 Aug 20;15(8):e43790. doi: 10.7759/cureus.43790. eCollection 2023 Aug.

Authors

Gülsen Şener¹, Esma İnan Yuksel², Osman Gökdeniz³, Kübra Karaman⁴, Harbiye Dilek Canat³

Affiliations

¹ Biochemistry, Başakşehir Çam and Sakura City Hospital, İstanbul, TUR.
² Dermatology, Biruni University Hospital, Istanbul, TUR.
³ Dermatology, Başakşehir Çam and Sakura City Hospital, İstanbul, TUR.
⁴ Biochemistry, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR.

Abstract

Objectives: Systemic inflammation has an important role in psoriasis, which is a chronic disease with an increasing prevalence and is associated with comorbidity. Our aim is to investigate the relationship of hematological parameters and C-reactive protein (CRP) with the presence and severity of the disease in patients with psoriasis. It is also to investigate whether it can be used as a biomarker in monitoring the response to systemic treatment.

Materials and methods: This retrospective study was conducted with the participation of 139 psoriasis patients receiving biological therapy (BT) and conventional therapy (CT) and 140 healthy controls. Demographic, clinical, and laboratory data of patients and controls were examined and all parameters were compared with the psoriasis area severity index (PASI) score. In addition, the changes in these parameters before the treatment and in the third month of the treatment were examined in the patient groups who received BT and CT.

Results: White blood cell (WBC), neutrophil, monocytes, platelet (PLT), plateletcrit, red blood cell, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) monocyte-lymphocyte ratio (MLR), red cell distribution width (RDW), CRP and erythrocytesedimentation (ESR) levels were higher compared to the healthy control group in psoriasis patients (p<0.05). Baseline PASI values were positively correlated with WBC, neutrophils, monocytes, NLR, MLR, and CRP. WBC, neutrophil, NLR, CRP, and ESR levels decreased in all patients in the third month of treatment (p<0.05). WBC, PLT, neutrophil, and NLR in patients receiving BT; while WBC, neutrophil, NLR, CRP, and ESR levels decreased in patients receiving CT, RDW levels increased (p<0.05). Adalimumab; NLR and basophil, methotrexate; WBC, NLR, neutrophil, and ESR levels caused a significant decrease (p<0.05).

Conclusion: The fact that increased WBC, neutrophils, monocytes, NLR, MLR, and CRP levels are associated with the severity of psoriasis indicates that these parameters reflect systemic inflammation in psoriasis. In addition, the decrease in these parameters after BT and CT suggests that they can be considered simple and reliable markers that can be used as a complement to the PASI score in assessing disease severity and response to treatment.

Keywords: crp; monocyte to lymphocyte ratio; neutrophil lymphocyte ratio; platelet to lymphocyte ratio; psoriasis severity index.