Serum Levels of Parathyroid Hormone and Parathyroid‐related Peptide in Psoriasis

Abstract

Psoriasis is a common skin disorder that may be triggered by hormonal disturbances, among other factors. Some studies have demonstrated an elevation of serum parathyroid hormone (PTH) levels in psoriasis and several other diseases of keratinization of unknown aetiology. PTH-related peptide (PTH-rp), on the other hand, is a potent inhibitor of epidermal cell growth factor and is not expressed in psoriatic skin. Serum levels of this peptide have not been reported in psoriasis. Immunoassay was used to measure serum PTH and PTH-rp in 22 patients with plaque-type psoriasis before and after treatment with mometasone furoate. Results were compared with a group of 20 healthy, non-psoriatic volunteers. Serum PTH levels were significantly elevated in the psoriatic group compared with the control group (p=0.001) and were significantly reduced after treatment (p=0.01). A correlation was found between pretreatment serum PTH levels and psoriasis area and severity scores (PASI) (r=0.42; p=0.01). In contrast, serum PTH-rp levels were not different between psoriatics and controls and were not affected by treatment. These findings indicate that serum PTH concentrations reflect disease activity in patients with psoriasis.

Relationship between parathyroid hormone and subclinical myocardial dysfunction in patients with severe psoriasis

“…Recent studies have shown that patients with psoriasis have an elevated serum level of PTH that correlates with PASI and is reduced upon treatment . Hyperparathyroidism has also been observed in other skin disorders characterized by keratinization .…”

“…Hyperparathyroidism has also been observed in other skin disorders characterized by keratinization . Although the exact mechanism remains unclear, it has been postulated that loss of calcium through the skin in these conditions can stimulate PTH synthesis . Alternatively, hyperparathyroidism can be secondary to vit‐D deficiency status as observed in patients with psoriasis .…”

“…Recent studies have shown that patients with psoriasis have an elevated serum level of PTH that correlates with PASI and is reduced upon treatment. 20 Hyperparathyroidism has also been observed in other skin disorders characterized by keratinization. 36,37 Although the exact mechanism remains unclear, it has been postulated that loss of calcium through the skin in these conditions can stimulate PTH synthesis.…”

“…36,37 Although the exact mechanism remains unclear, it has been postulated that loss of calcium through the skin in these conditions can stimulate PTH synthesis. 20 Alternatively, hyperparathyroidism can be secondary to vit-D deficiency status as observed in patients with psoriasis. 19 Nevertheless, the present results revealed no differences regarding the serum 25-OHD level and the prevalence of vit-D deficiency between patients with severe psoriasis and controls.…”

“…17,18 Recent studies have shown a high prevalence of vit-D deficiency 19 and hyperparathyroidism in patients with psoriasis, attributed to chronic loss of calcium from the inflamed skin. 20 We hypothesized that suboptimal vit-D status and/or hyperparathyroidism are associated with myocardial dysfunction in patients with severe psoriasis. We therefore performed detailed echocardiography, including two-dimensional (2D) speckle tracking derived strains, and measured the plasma levels of 25-hydoxyvitamin D (25-OHD) and PTH in patients with severe psoriasis.…”