Impact of antipsoriatic therapy on endothelial function.
BACKGROUND
Endothelial function (EF) impairment is one of the first events in the process of atherosclerosis, which is known to be associated with psoriasis. Nevertheless, the effect of antipsoriatic treatments, some of them with atherogenic risks, on cardiovascular morbidity and EF is still unclear.


OBJECTIVE
To investigate the effect of short-term antipsoriatic treatments on EF values as a potential marker of their effect on cardiovascular morbidity.


METHODS
EF was evaluated in 26 patients with moderate-to-severe psoriasis by measuring microvascular blood flow, expressed as the reactive hyperaemia index (RHI), before and after phototherapy (8 weeks) or systemic antipsoriatic treatment (12 weeks).


RESULTS
Antipsoriatic intervention was effective (46% achieving ≥ 75% improvement in Psoriasis Area and Severity Index), while the average RHI did not improve during the study (1·73 ± 0·48. vs. 1·66 ± 0·35, average difference -0·12 ± 0·43, not significant). Patients with baseline preserved EF exhibited a decline in RHI (difference -0·2 ± 0·4, P = 0·053), while patients with abnormal baseline RHI presented nonsignificant RHI improvement (RHI difference 0·1 ± 0·2).


CONCLUSIONS
There was no positive effect on EF of short-term antipsoriatic treatment. It is possible that a longer period of treatment and EF evaluation would uncover a positive endothelial effect, especially in patients with baseline abnormal EF.
Department of Dermatology, Haemek Medical Center, Afula, 18101, Israel.
E
E
Cohen-Barak
Department of Dermatology, Haemek Medical Center, Afula, 18101, Israel.
M
M
Sah
Department of Dermatology, Haemek Medical Center, Afula, 18101, Israel.
M
M
Kerner
Department of Dermatology, Haemek Medical Center, Afula, 18101, Israel.
D
D
Rozenman
Department of Dermatology, Haemek Medical Center, Afula, 18101, Israel.
M
M
Ziv
D000328:Adult; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D011565:Psoriasis / Q000628:therapy*; D014467:Ultraviolet Therapy / Q000379:methods*
D002317:Cardiovascular Agents; D003879:Dermatologic Agents