Factors associated with the length of remission of psoriasis vulgaris.

BACKGROUND: Cardiovascular risk factors are found with significantly high frequency in psoriatic patients. Periods of remission and reactivation of lesions are common in psoriasis.
OBJECTIVE: Considering the association of chronic inflammation with the atherogenic process, we aimed to search for a possible relationship between the lipid profile, adipokine levels and body mass index (BMI) at the end of a successful treatment for psoriasis, and the length of remission of psoriasis.
METHODS: Forty-three patients were clinically and analytically studied after a successful treatment [as shown by Psoriasis Area and Severity Index (PASI)]--nine treated with topical agents, 17 with narrow-band UV light B (NB-UVB) and 17 with psoralen plus UVA-and were followed to record the length of remission.
RESULTS: The length of psoriasis remission correlated negatively and significantly with cholesterol levels, which correlated significantly and positively with C-reactive protein (CRP). In multiple linear regression analysis, cholesterol, CRP, PASI and BMI were associated with the length of remission. Patients with cholesterol levels <200 mg/dL (n = 13) presented a significantly longer remission, lower BMI and triglycerides values, and a trend towards lower PASI and CRP values than those with high cholesterol (n = 30). Considering patients according to the treatment used, cholesterol was also associated with length of remission, especially for patients treated with NB-UVB and topical therapy.
CONCLUSION: Psoriasis patients with the highest cholesterol levels presented higher BMIs, triglycerides levels and shorter remission periods. Our data suggest that the identification of potentially treatable conditions, such as dyslipidaemia and obesity, and their adequate treatment may benefit psoriasis patients by increasing the length of remission of the disease.