The Putative Role of Thyroid Hormones and Vitamin D on Severity and Quality of Life in Psoriasis

INTRODUCTION: Psoriasis is a chronic immune-mediated inflammatory skin disease. The thyroid hormone receptors are expressed in human skin and the hormones exert their effects on epidermal proliferation and differentiation; they have been hypothesized to play a role in the pathogenesis of psoriasis. Vitamin D is involved in the maintenance of cutaneous barrier homeostasis. Several studies identified an association between polymorphisms of Vitamin D receptor and psoriasis susceptibility. SUBJECTS AND METHODS: Thirty clinically diagnosed psoriasis patients in the age group between 20 and 50 years of both genders attending the outpatient department of dermatology were included as cases. Thirty healthy subjects attending routine health checkup were included as controls. Serum 25 hydroxycholecalciferol was estimated in Mini Vidas autoanalyzer by immunofluorescence technique and Thyroid stimulating hormone (TSH), free T3, and free T4 were estimated by chemiluminescence technology in Cobas e411. Dermatology quality of life index (DLQI) and psoriasis area severity index (PASI) questionnaire was used to assess the quality of life and severity of psoriasis respectively. RESULTS: TSH level was significantly increased in psoriasis cases when compared to healthy controls but within reference range (P < 0.05). There is a significant negative correlation between PASI and 25-hydroxycholecalciferol and significant negative correlation between PASI and DLQI. CONCLUSION: Our study emphasizes the relationship between biochemical markers, severity of psoriasis, and quality of life. A multimodal holistic approach is needed for the treatment of psoriasis. Psychological support for stress management, drug therapy, and biochemical markers assessment for severity of psoriasis are the need of the hour.