Estimation of Serum Trace Elements Levels in Libyan Patients with Psoriasis Vulgaris: A Case Control Study
International Journal of Clinical Dermatology
Volume 3, Issue 1, June 2020, Pages: 15-18
Received: Apr. 4, 2020;
Accepted: Apr. 22, 2020;
Published: Jun. 9, 2020
Views 307 Downloads 32
Nadia Abdalhafid El Sherif, Dermatology Department, Faculty of Medicine, Benghazi University, Benghazi, Libya
Salwa Abdalsalam El-Dibany, Dermatology Department, Omar El-Mukhtar University, Al-Beida, Libya
Background: Psoriasis is a chronic autoimmune skin disease with a worldwide prevalence of 2–3%. Psoriasis is caused by a complex interplay among the immune system, genetic background, auto-antigens, and environmental factors. Trace elements are required for the normal functioning of many enzymes and play a significant role in the development of many diseases. Objective: To assess the serum levels of zinc, copper, magnesium, iron and folate in patients with psoriasis compared to healthy controls. Patients and Methods: A total of 41 patients with psoriasis vulgaris were compared with 50 age and sex matched healthy subjects. Serum levels of zinc (Zn), copper (Cu), magnesium (Mg), iron (Fe) and folate were measured in both groups and compared. Psoriasis Area and Severity Index (PASI) were used to measure the severity of the disease. Results: The mean serum level of Zn was 142.2±52 in patients compared to 90.2±18.9 in the controls (P=.000), serum level of Cu was 161.1±58.5 in patients versus 156.3±42.8 in control group (P=.650). Serum Mg was 2.4±0.5 in patients and 1.9±0.2 in control subjects (P=.000). Serum Fe was 90.8±50 in patients as compared to 116.9±32.4 in control subjects (P=.004), whereas, serum folate was 6.6±3.9 in patients and 9.5±5.3 in control subjects (P=.005). There was no significant direct correlation between levels of trace elements under study and PASI scoring. Conclusions: Trace elements particularly Zn, Cu, and Mg appear to be elevated in psoriasis patients, while Fe and folate were low in psoriatic patients, however, they can't serve as biomarkers for disease activity.
Nadia Abdalhafid El Sherif,
Salwa Abdalsalam El-Dibany,
Estimation of Serum Trace Elements Levels in Libyan Patients with Psoriasis Vulgaris: A Case Control Study, International Journal of Clinical Dermatology.
Vol. 3, No. 1,
2020, pp. 15-18.
Hawkes J. E., Chan T. C. and Krueger J. G. Psoriasis pathogenesis and the development of novel targeted immune therapies. J. Allergy Clin. Immunol. 2017; 140, 645–653.
Nigam P K. Serum zinc and copper levels and Cu: Zn ratio in psoriasis. Indian J Dermatol Venereol Leprol 2005; 71: 205-6.
Basavaraj KH, Darshan MS, Shanmugavelu P, Rashmi R, Mhatre AY, Dhanabal SP, Rao KS. Study on the levels of trace elements in mild and severe psoriasis. Clin Chim Acta. 2009; 405 (1-2): 66-70.
Wacewicz M, Socha K, Soroczyńska J, Niczyporuk M, Aleksiejczuk P, Ostrowska J, Borawska MH. Concentration of selenium, zinc, copper, Cu/Zn ratio, total antioxidant status and c-reactive protein in the serum of patients with psoriasis treated by narrow-band ultraviolet B phototherapy: A case-control study. J Trace Elem Med Biol. 2017; 44: 109-114.
Butnaru C., Pascu M., Mircea C. Serum zinc and copper levels in some dermatological diseases. Rev. Med. Chir. Soc. Med. Nat. Iasi. 2008; (1): 253-57.
Darlenski R, Hristakieva E, Aydin U, Gancheva D, Gancheva T, Zheleva A, Gadjeva V, Fluhr JW. Epidermal barrier and oxidative stress parameters improve during in 311 nm narrow band UVB phototherapy of plaque type psoriasis. Dermatol Sci. 2018; 91 (1): 28-34.
Elhaddad H, Morsy R, Mourad B, Elnimr T. A comprehensive study on the content of serum trace elements in psoriasis. J. Elem. 2017; (1): 31-42.
Sheikh G, Masood Q, Majeed S, Hassan I. Comparison of levels of serum copper, zinc, albumin, globulin and alkaline phosphatase in psoriatic patients and controls: A hospital based case control study. Indian Dermatol Online J 2015; 6: 81-3.
Shahidi-Dadras M, Namazi N, Younespour S. Comparative Analysis of Serum Copper, Iron, Ceruloplasmin, and Transferrin Levels in Mild and Severe Psoriasis Vulgaris in Iranian Patients. Indian Dermatol Online J. 2017; 8 (4): 250-253.
Rashmi R, Yuti AM, Basavaraj KH. Relevance of copper and ceruloplasmin in psoriasis. Clin Chim Acta 2010; 411: 1390-2.
Ala S, Shokrzadeh M, Golpour M, Salehifar E, Alami M, Ahmadi A. Zinc and copper levels in Iranian patients with psoriasis: A case control study. Biol Trace Elem Res 2013; 153: 22-7.
Gaetke L. M., Chow C. K. Copper toxicity, oxidative stress, and antioxidant nutrients. Toxicology, 2003; (1-2): 147-163.
Madadi A, Sethi N, Bhandari S. A study of serum zinc, copper, magnesium, proteins and enzyme superoxide dismutase in psoriasis. Indian J Dermatol Venereol Leprol. 1994; 60: 319-322.
Rashmi R., Yuti A. M., Basavaraj K. H. Enhanced ferritin/iron ratio in psoriasis. Ind. J. Med. Res. 2012; 135 (5): 662-665.
Sato S. Iron deficiency: structural and microchemical changes in hair, nails, and skin. Semin. Dermatol. 1991; 10 (4): 313-19.
Tsai TY, Yen H, Huang YC. Serum homocysteine, folate and vitamin B12 levels in patients with psoriasis: a systematic review and meta-analysis. Br J Dermatol. 2019; 180 (2): 382-389.
Brazzelli V, Grasso V, Fornara L, Moggio E, Gamba G, Villani S, Borroni G. Homocysteine, vitamin B12 and folic acid levels in psoriatic patients and correlation with disease severity. Int J Immunopathol Pharmacol. 2010; 23 (3): 911-6.
Malerba, M., Gisondi, P., Radaeli, A., Sala, R., Calzavara Pinton, P. G. and Girolomoni, G. Plasma homocysteine and folate levels in patients with chronic plaque psoriasis. Br. J. Dermatol. 2006; 155, 1165–1169.
Lin X, Meng X, Song Z. Homocysteine and psoriasis. Biosci Rep. 2019; 39 (11).