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CHALLENGING CORRELATIONS BETWEEN PSORIASIS SEVERITY AND TNF-α LEVELS IN HARD-TO-TREAT AREAS

ALIN CODRUȚ NICOLESCU 1,2#, ȘTEFANA BUCUR 1,3*, IOAN ANCUȚA 1,4#, SÂNZIANA IONESCU 1,5, DACIANA ELENA BRĂNIȘTEANU 6,7, MARIA-MAGDALENA CONSTANTIN 1,3

1Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474, Bucharest, Romania
2“Agrippa Ionescu” Emergency Clinical Hospital, 011773, Bucharest, Romania
3IInd Department of Dermatology, Colentina Clinical Hospital, 020125, Bucharest, Romania
4Department of Rheumatology, “Dr. I. Cantacuzino” Clinical Hospital, 020475, Bucharest, Romania
5Surgery Department I, “Prof. Dr. Al. Trestioreanu” Bucharest Oncology Institute, 022328, Bucharest, Romania
6“Grigore T. Popa” University of Medicine and Pharmacy, Faculty of Medicine, Department of Dermatology, 700115, Iași, Romania
7Dermalux, Iași, Romania

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The current study highlights the important role of tumour necrosis factor-α (TNF-α) in the development of psoriasis and suggests that an assessment of serum TNF-α levels might be useful as a predictor of psoriasis severity. Furthermore, these results could answer the dilemma raised by this article itself, more precisely the cause of the severity of special sites. We evaluated a group of 47 patients for the possible link between the severity according to Psoriasis Area and Severity Index (PASI), Psoriasis Scalp Severity Index (PSSI), Nail Psoriasis Severity Index (NAPSI), or Erythema, Scaling, Induration, Fissuring Scale (ESIF) scores and pro-inflammatory cytokines profile in difficult-to-treat areas. The severity of the disease was assessed using PASI and other scores dedicated to these special sites. The correlation between the PASI score and serum TNF-α was evaluated. Serum TNF-α levels are significantly increased in patients with severe psoriasis, which is correlated with the PASI score, and are within limits as long as the PASI score is lower, regardless of the severity of the difficult-to-treat areas. Deciphering the cause of the severity of special sites might change the therapeutic approach in order to personalise therapy according to the cytokine profile and increase access to biological therapies with significant benefits for the patient.