Role of HCV Infection in Psoriasis: A Clinical and Immunohistochemical Study

摘要

Psoriasis is a common inflammatory skin disorder in which different infections play an important role in its pathogenesis. It was proposed that Hepatitis C Virus (HCV) is involved in psoriasis pathogenesis, and may contribute to its severity. This hypothesised role of HCV in psoriasis emerged through investigating serum HCV antibody and plasma HCV RNA levels, however till date, no study investigated HCV protein in skin of psoriasis patients.Aim: To investigate the role of HCV in aetiopathogenesis of psoriasis through evaluation of HCV protein immunohistochemical expression in lesional skin biopsies of HCV positive psoriatic patients compared to non-psoriatic patients and controls.Materials and Methods: Twenty HCV positive psoriatic patients (32-65 years) in addition to 20 age and sex matched HCV positive non-psoriatic patients (31-58 years) and 20 healthy control subjects (36-57 years) were included in this case-control study. Psoriasis Area Severity Index (PASI) score was used to evaluate psoriasis severity. Skin biopsies were taken from all groups and were stained with Haematoxylin and Eosin stain (H and E) and immunohistochemically by HCV protein monoclonal antibody.Results: HCV protein immunoreactivity was significantly decreased in HCV positive psoriatic patients than non-psoriatic patients (p=0.02), however, its percentage and H-score mean values were significantly elevated in psoriatic than non-psoriatic HCV positive cases (p=0.044 and p=0.03 respectively). HCV protein expression was positively associated with psoriasis severity (p=0.032) and its cutaneous load was positively associated with disease duration (p=0.05).Conclusion: Not the presence of HCV infection, but its cutaneous load may have an active role in pathogenesis of psoriasis. This cutaneous load was positively associated with disease duration. Moreover, HCV infection is associated with psoriasis severity.