Dermoscopic Features And Serum Levels Of IL-17C And IL-23 In Advanced And Regressive Stages Of Psoriasis Vulgaris

Objective:The purpose of this study is to explore the role of dermoscopy in the diagnosis and stages of psoriasis vulgaris;to detect the expression levels of IL-17 C and IL-23 in the peripheral serum of patients with psoriasis vulgaris,and to analyze their changes in the advanced and regressive phases of psoriasis vulgaris and their correlation with the Psoriasis Area and Severity Index(PASI score).Methods: Selecting target lesions from 35 patients with advanced psoriasis vulgaris.which were examined by dermoscopy with background color,blood vessel distribution,vasodilatation and scale.After treatment,the target lesions of the same site were examined by dermoscopy again when the lesions reached the stage of regression.Detecting the serum levels of IL-17 C and IL-23 by ELISA in 35 patients with psoriasis vulgaris at the advanced and regressive stages and 12 normal controls.Evaluating the patients with psoriasis vulgaris by PASI,and analyzing the correlation between PASI score and the concentration of IL-23 in peripheral blood.Results:1.The background of skin lesions in patients with psoriasis vulgaris in the advanced stage under dermoscopy is bright red,with uniform distribution of spherical,hairpin and punctate blood vessels,surrounded by silver-white scales.The background of the skin lesions in the regressive phase is dark red,with scattered dot-shaped dilated blood vessels,and a little white scale on the periphery.The dermoscopic severity score of psoriasis vulgaris in progressive stage and retrogressive stage were 2.63 ±0.490 and0.67 ±0.547 respectively.The comparison of the dermoscopic scores between the two groups was Z=-6.824,and there was a statistically significant difference between the two groups(P<0.05).2.Variation of IL-23 concentration in peripheral serum(pg/ml): The mean value of the advanced psoriasis group was(136.362±13.024),and the mean value of the regressive group was(104.003±10.440),both higher than the normal control group(52.884±8.082).The test of variance among the three groups showed that the difference was statistically significant(F=239.177,P<0.05).In the advanced group,there was a positive correlation between peripheral serum IL-23 and clinical PASI score by Pearson correlation analysis(r=0.755,P<0.05).3.Variation of IL-17 C concentration in peripheral serum(pg/ml): The mean value of Psoriasis Vulgaris in the advanced stage group was(399.999±130.741),and the mean value in the regressive stage group was(375.247±132.112),which was higher than the normal control group(354.114±100.305).The test of variance among the three groups showed that the difference was not statistically significant(F=0.633,P>0.05).Conclusion:1.Dermatoscopy can better reflect the color,blood vessels and scales of skin lesions in patients with psoriasis vulgaris through non-invasive examination,and provide imaging basis for the diagnosis,differential diagnosis and staging of psoriasis vulgaris.The vascular severity score under dermoscopy can be used as one of the indicators to evaluate the severity of psoriasis.2.The high expression of IL-23 in the peripheral serum of patients with psoriasis vulgaris indicates that the incidence of psoriasis vulgaris is related to IL-23.The concentration of IL-23 in peripheral serum can be used as an indicator of the progress and severity of psoriasis vulgaris.3.The IL-17 C in the peripheral serum of patients with psoriasis vulgaris may not be used as an indicator of the progress and severity of psoriasis vulgaris,and further research is needed.