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Ultraviolet (UV) phototherapy is a standard treatment for many inflammatory dermatological diseases, including psoriasis. The systemic effects of UV phototherapy are still not well studied. There are several factors that may affect patient's cardiovascular (CV) risk during UV phototherapy. Atherosclerosis is now known to have an inflammatory origin and to be frequently associated with psoriasis. In this study the investigators aim at studying the effect of psoralen-UVA phototherapy on several biomarkers of CV risk in patients with psoriasis with or without atherosclerosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High risk group | Active Comparator | Patients with psoriasis and atherosclerosis will receive PUVA therapy for 36 sessions divided as 3 sessions weekly |
|
| Low risk group | Active Comparator | Patients with psoriasis but no atherosclerosis detected, will receive PUVA therapy for 36 sessions divided as 3 sessions weekly |
|
| Control group | No Intervention | Age-matching apparently normal individuals will receive no interventions but will perform investigational tests. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PUVA | Radiation | 36 sessions of psoralen-ultraviolet A, divided as 3 sessions weekly |
|
| Measure | Description | Time Frame |
|---|---|---|
| Comparative change in photoinduced oxidation and related change in cardiovascular risk between both risk groups in response to photochemotherapy | Comparison between both risk groups in the amount of change between baseline level and end of study level of oxidized low density lipoprotein | day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Measure | Description | Time Frame |
|---|---|---|
| comparative number of patients with metabolic syndrome after therapy in both groups | Comparison between both risk groups as regards the number of patients with metabolic syndrome | end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Comparative changes in metabolic syndrome component 1: waist circumference |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dermatology department - faculty of medicine- Cairo University | Cairo | Egypt |
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| ID | Term |
|---|---|
| D011565 | Psoriasis |
| D050197 | Atherosclerosis |
| D024821 | Metabolic Syndrome |
| ID | Term |
|---|---|
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001161 | Arteriosclerosis |
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Comparison between both risk groups in the amount of change between baseline level and EOS level of waist circumference |
| day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Comparative changes in metabolic syndrome component 2: arterial blood pressure | Comparison between both risk groups in the amount of change between baseline level and EOS level of arterial blood pressure | day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Comparative changes in metabolic syndrome component 3: blood sugar | Comparison between both risk groups in the amount of change between baseline level and EOS level of blood sugar | day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Comparative changes in metabolic syndrome component 4: serum lipids | Comparison between both risk groups in the amount of change between baseline level and EOS level of serum lipids | day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| Atherosclerotic changes in the high risk group in response to PUVA | comparison of duplex arteriography findings in the high risk group between before and after treatment | end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) |
| Correlation between cutaneous response and systemic response to photochemotherapy in both risk groups | Correlation between PASI score after treatment and other parameters of systemic response (hs-CRP, ox-LDL, metabolic syndrome components) | day 0 to end of 12 weeks (end of 36 sessions, 3 sessions weekly of photochemotherapy) and/or clinical cure whichever comes first |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007333 | Insulin Resistance |
| D006946 | Hyperinsulinism |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |