Topic: BusinessManagement

Last updated: February 11, 2019

Psoriasis is a chronic inflammatory condition.

Micro and macrovascular complication has been established complication of psoriasis. MPV, NLR and PLR are proven biomarkers of inflammation and platelet activation. Risk of cardiovascular and thrombotic complication can be minimized with early recognition and prevention.

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These three markers are cheap ,convenient and easily accessible even in the rural area.Ahmed et al., (2015) showed that MPV was higher in psoriasis patient in relation to healthy indvidual in a case control study of total 60 subjects. MPV shows significantly higher in psoriasis patient in comparison to the healthy individuals by using independent sample t test.

The mean value of MPV in psoriasis patients group was 8.24±1.22 fl where as in helathy individuals of the control group it was 7.29±0.77 fl. P value was significant (P=0.

001), when comparison of means of MPV in both group was observed. Investigator concluded as this abnormal morphology along with increased platelet activation ultimately results of long term micro and macro vascular complication of this disease, MPV-a simple cost effective test which can identify risk of cardiovascular diseases, can be used as a tool to start early preventive measure. In a study done by Kim D. et al., (2016) it was found that MPV is not only increased in psoriasis but it also have positive correlation with disease severity of psoriasis calculated by PASI score. Total one hundred and seventy-six (167) psoriasis patients and 101 healthy controls were observed in this study . In psoriasis patients, they observed that PASI, most commonly used clinical assessment tool for disease severity, significantly correlated with MPV (r=0.

189, p=0.006). However,they divided patients according to their PASI score. Where PASI?10 was regarded as moderate to severe psoriasis and PASI 0.05). Higher PMI and MPV values, which mean higher plaque formation capacity and more active platelets, in psoriasis may make psoriasis patients more sensitive to atherosclerotic plaque formation and complications. On the other hand, because of the positive PMI correlation with ESR (MPV had no correlatin with ESR and had a negative correlation with CRP), PMI may be a better predictor of inflammation than MPV in psoriasisIn another case control study conducted at ?i?li Hamidiye Etfal Training and Research Hospital over fourty-nine patients with chronic plaque psoriasis and fourty-seven controls reveals neutrophil-lymphocyte ratio levels were significantly higher in patients with psoriasis than in healthy controls (p0.05).

As recent studies has been mentioned that the neutrophil-lymphocyte ratio and mean platelet volume have prognostic importance for cardiovascular diseases assessment and management of the inflammatory status in psoriasis patients is important to prevent the comorbidities such as cardiovascular diseases. For this purpose author suggested that neutrophil-lymphocyte ratio might be considered as an easily accessed, available and cost-effective laboratory marker. (Çerman et al, 2016)Another case control study over seventy-six patients with psoriasis and 76 sex and age-matched controls were retrospectively evaluate by senel et al.,(2015) The study has not found any significance. The mean MPV values were 8.96 ± 1.03 fL for psoriasis and 8.75 ± 1.

07 fL forcontrol groups. No significant difference was also found between the patients and controls regarding mean MPV values (p=0.231 and p=0.295, t test and Mann Whi tney-U test,respectively). They also measured no correlation between PASI scores and MPV levels . As they didnot found any significance, so suggested for large population study for further clarification.

A Case control study was carried out on 50 psoriatic patients and 50 healthy control subjects. Total ten haematologic parameters were compared between patients and control subjects. These parameters were also correlated in patients with PASI (Psoriasis Area and Severity Index) score. When all the patients were considered together, mean values for MPV, Platelet Count (PLT) and Red Cell Distribution Width (RDW) were significantly different between the two groups (Control and Patients).

While MPV and RDW were raised, PLT was reduced in patients of both sexes when compared with controls. In Male patients the MPV and RDW showed statistically significant correlation with Psoriasis Area And Severity Index (PASI) (MPV


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