الفهرس 
NTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Psoriasis is an inflammatory disease of the skin characterized by an accelerated rate of epidermal turnover, with hyperproliferation and defective maturation of epidermal keratinocytes. The lesions of psoriasis are distinctive. They begin as red, scaling papules that coalesce to form round-to-oval plaques, which can easily be distinguished from the surrounding normal skin. The scale is adherent and silvery white, and reveals bleeding points when removed (Auspitz sign).
The most common form is the chronic plaque psoriasis which manifests as well-demarcated, often symmetrically distributed, thickened, red, scaly plaques. The prevalence of psoriasis is relatively high in the general population, ranging between 0.6% and 4.8%. There is a familial incidence of 40%.
Psoriasis is considered a T-cell-mediated inflammatory skin disease, with a predominance of type 1 cytokines.The etiology of psoriasis remains largely unknown; however, the disease has genetic and autoimmune components. Cytokines are now considered to be the primary mediators of cutaneous inflammation in psoriasis. numerous clinical trials have suggested that adipocyte-derived cytokines may be involved in the pathogenesis of psoriasis, and also may be a pathogenetic cofactor contributing to chronicity of the disease
Adiponectin belongs to a family of adipokines, which are a group of cytokines mainly secreted by adipose tissue. Adiponectin is a regulator of insulin sensitivity and metabolism and serum adiponectin is closely related to metabolic syndrome. Accumulated evidence shows that adiponectin exerts anti-inflammatory properties in various cells.
Adiponectin significantly suppressed production of TNF-α, IL-6, IL-8 and IL-12 in a dose-dependent manner. Furthermore, adiponectin inhibited TNF-α-induced production of IL-6 in normal human keratinocytes. These results indicated that adiponectin exerts anti-inflammatory properties in keratinocytes in vitro.
Psoriasis is associated with the complex disorder of metabolic syndrome, which incorporates hypertension, dyslipidemia, obesity, and impaired glucose tolerance, and that the association is stronger for severe psoriasis compared with mild psoriasis.
The present work aimed to study the serum levels of adiponectin in obese and normal-weight psoriatic patients. The study was carried out on fourty patients with psoriasis and fourty healthy controls of matched age, sex and BMI. Fourty patients were selected from the outpatient’s dermatology clinic of Alexandria Main University Hospital.
Patients exclusion criteria: Patients and controls who had received systemic treatments within one month prior to study entry were excluded.
Blood samples were collected from patients and controls for measuring Serum adiponectin levels using ELISA technique.
The present study revealed a statistically significant higher serum levels of adiponectin in normal weight psoriatic patients compared to normal weight healthy controls while obese patients with psoriasis had decreased serum levels of adiponectin compared to normal weight patients and obese healthy controls. Adiponectin levels in control group were also significantly higher in normal weight subjects compared to obese ones.